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Hemodynamic Effects of Epicardial Stenoses

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Physiological Assessment of Coronary Stenoses and the Microcirculation

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Abstract

This chapter starts by a brief review of coronary physiology in terms of pressure-flow relationships and effects of vessel distensibility on microvascular resistance to lay the foundation for interpretation of coronary stenosis hemodynamics. The fluid dynamics of stenosis pressure gradient, resistance, and its dependency on flow and stenosis dimensions is outlined in the next section. Special consideration is given to serial lesions, stenosis compliance, and diffuse coronary narrowing. The last section discusses the hemodynamic effect of coronary epicardial stenoses on coronary blood flow and the need for integration of multiple physiological parameters to arrive at a well-founded procedural decision for an individual patient suffering from ischemic heart disease.

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Authors and Affiliations

  1. Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, 1105AZ, Amsterdam, the Netherlands

    Lorena Casadonte MD & Maria Siebes MD

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  1. Lorena Casadonte MD
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  2. Maria Siebes MD
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Correspondence to Lorena Casadonte MD or Maria Siebes MD .

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  1. Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain

    Javier Escaned

  2. Imperial College London, London, United Kingdom

    Justin Davies

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Casadonte, L., Siebes, M. (2017). Hemodynamic Effects of Epicardial Stenoses. In: Escaned, J., Davies, J. (eds) Physiological Assessment of Coronary Stenoses and the Microcirculation. Springer, London. https://doi.org/10.1007/978-1-4471-5245-3_1

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  • DOI: https://doi.org/10.1007/978-1-4471-5245-3_1

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