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10.1136/heartjnl-2024-324039 http://scihub22266oqcxt.onion/10.1136/heartjnl-2024-324039 38754969!ä!38754969 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Heart 2024 ; ä (ä): ä Nephropedia Template TP {{tp|p=38754969|t=2024. Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4) |pdf=|usr=}}{{38754969}} gab.com Text Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4) JO: Heart http://www.kidney.de/pget.php?&tw=1&pmid=38754969 #FOAvip BACKGROUND: The practical application of 'virtual' (computed) fractional flow reserve (vFFR) based on invasive coronary angiogram (ICA) images is unknown. The objective of this cohort study was to investigate the potential of vFFR to guide the management of unselected patients undergoing ICA. The hypothesis was that it changes management in >10% of cases. METHODS: vFFR was computed using the Sheffield VIRTUheart system, at five hospitals in the North of England, on 'all-comers' undergoing ICA for non-ST-elevation myocardial infarction acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The cardiologists' management plan (optimal medical therapy, percutaneous coronary intervention (PCI), coronary artery bypass surgery or 'more information required') and confidence level were recorded after ICA, and again after vFFR disclosure. RESULTS: 517 patients were screened; 320 were recruited: 208 with ACS and 112 with CCS. The median vFFR was 0.82 (0.70-0.91). vFFR disclosure did not change the mean number of significantly stenosed vessels per patient (1.16 (+/-0.96) visually and 1.18 (+/-0.92) with vFFR (p=0.79)). A change in intended management following vFFR disclosure occurred in 22% of all patients; in the ACS cohort, there was a 62% increase in the number planned for medical management, and in the CCS cohort, there was a 31% increase in the number planned for PCI. In all patients, vFFR disclosure increased physician confidence from 8 of 10 (7.33-9) to 9 of 10 (8-10) (p<0.001). CONCLUSION: The addition of vFFR to ICA changed intended management strategy in 22% of patients, provided a detailed and specific 'all-in-one' anatomical and physiological assessment of coronary artery disease, and was accompanied by augmentation of the operator's confidence in the treatment strategy. Twit Text FOAVip Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4) ????Heart http://www.kidney.de/pget.php?&tw=1&pmid=38754969 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=38754969 #FOAvip English Wikipedia <ref>{{Cite pmid|38754969}}</ref> Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4) #MMPMID38754969 Ghobrial M; Haley H; Gosling R; Taylor DJ; Richardson J; Morgan K; Barmby D; Iqbal J; Krishnamurthy A; Singh R; Conway D; Hall I; Adam Z; Wheeldon N; Grech ED; Storey RF; Rothman A; Payne G; Tahir MN; Smith S; Cooke J; Hunter S; Cartwright N; Sadeque S; Briffa NP; Al-Mohammad A; O'Toole L; Rogers D; Lawford PV; Hose DR; Gunn J; Morris PD Heart 2024[May]; ä (ä): ä PMID38754969show ga BACKGROUND: The practical application of 'virtual' (computed) fractional flow reserve (vFFR) based on invasive coronary angiogram (ICA) images is unknown. The objective of this cohort study was to investigate the potential of vFFR to guide the management of unselected patients undergoing ICA. The hypothesis was that it changes management in >10% of cases. METHODS: vFFR was computed using the Sheffield VIRTUheart system, at five hospitals in the North of England, on 'all-comers' undergoing ICA for non-ST-elevation myocardial infarction acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The cardiologists' management plan (optimal medical therapy, percutaneous coronary intervention (PCI), coronary artery bypass surgery or 'more information required') and confidence level were recorded after ICA, and again after vFFR disclosure. RESULTS: 517 patients were screened; 320 were recruited: 208 with ACS and 112 with CCS. The median vFFR was 0.82 (0.70-0.91). vFFR disclosure did not change the mean number of significantly stenosed vessels per patient (1.16 (+/-0.96) visually and 1.18 (+/-0.92) with vFFR (p=0.79)). A change in intended management following vFFR disclosure occurred in 22% of all patients; in the ACS cohort, there was a 62% increase in the number planned for medical management, and in the CCS cohort, there was a 31% increase in the number planned for PCI. In all patients, vFFR disclosure increased physician confidence from 8 of 10 (7.33-9) to 9 of 10 (8-10) (p<0.001). CONCLUSION: The addition of vFFR to ICA changed intended management strategy in 22% of patients, provided a detailed and specific 'all-in-one' anatomical and physiological assessment of coronary artery disease, and was accompanied by augmentation of the operator's confidence in the treatment strategy. äModelled impact of virtual fractional flow reserve in patients undergo(epmc).pdf DeepDyve Pubget Overpricing