A systematic approach to the evaluation of the coronary microcirculation using bolus thermodilution: CATH CMD

Coronary microvascular dysfunction (CMD) can cause myocardial ischemia in patients presenting with angina without obstructive coronary artery disease (ANOCA). Evaluating for CMD by using the thermodilution technique offers a widely accessible means of assessing microvascular resistance. Through this technique, 2 validated indices, namely coronary flow reserve and the index of microcirculatory resistance, can be computed, facilitating investigation of the coronary microcirculation. The index of microcirculatory resistance specifically estimates minimum achievable microvascular resistance within the coronary microcirculation. We aim to review the bolus thermodilution method, outlining the fundamental steps for conducting measurements and introducing an algorithmic approach (CATH CMD) to systematically evaluate the coronary microcirculation. Embracing a standardized approach, exemplified by the CATH CMD algorithm, will facilitate adoption of this technique and streamline the diagnosis of CMD

Intramural hematoma appearing as a new lesion after coronary stenting

Case study - A 51-year-old man with hypertension and hyperlipidemia presented with exertional chest pain and underwent a stress echocardiogram that showed anterior and lateral ischemia

Adaption of tribological behavior of a-C:H coatings for application in dry deep drawing

Nowadays the sheet metal forming industry faces challenges regarding efficient usage of resources and sustainability. One strategy to increase the environmental friendliness is to abandon the application of lubricants. The direct contact between tool and workpiece leads to an intensive interaction which increases friction. Especially for deep drawing processes with long sliding distances, this causes distinctive wear. The tool sided application of carbon based coatings is a well-known approach to reduce friction and wear. Former studies have shown a beneficial behavior of hydrogenated amorphous carbon based coatings (a-C:H) to improve the tribological conditions in contact with steel sheets and aluminium alloys under dry conditions. Within this study the coating process and the resulting coating properties will be analyzed. Afterwards mechanical and laser based surface treatment processes prior and after the deposition process will be investigated to reduce the coating roughness. Different roughness values were achieved by varying the surface treatment processes. The laser based finishing enables a reduction of the Spk values by removing single roughness asperities. In order to identify the necessary process parameters for the laser treatment, an analytical model of the material removal was applied. The laser surface treatment achieved similar roughness characteristics compared to mechanical treatment. In this study the tribological behavior of a-C:H coated tools was analyzed under dry conditions within strip drawing tests. The tribological investigations revealed that for dry deep drawing of zinc coated DC04 a broader range of Spk values leads to acceptable tribological conditions whereas for AA5182 a smoother tool surface has to be ensured to prevent adhesion and utilize the full potential of a-C:H coatings

Adaption of tribological behavior of a-C:H coatings for application in dry deep drawing

Nowadays the sheet metal forming industry faces challenges regarding efficient usage of resources and sustainability. One strategy to increase the environmental friendliness is to abandon the application of lubricants. The direct contact between tool and workpiece leads to an intensive interaction which increases friction. Especially for deep drawing processes with long sliding distances, this causes distinctive wear. The tool sided application of carbon based coatings is a well-known approach to reduce friction and wear. Former studies have shown a beneficial behavior of hydrogenated amorphous carbon based coatings (a-C:H) to improve the tribological conditions in contact with steel sheets and aluminium alloys under dry conditions. Within this study the coating process and the resulting coating properties will be analyzed. Afterwards mechanical and laser based surface treatment processes prior and after the deposition process will be investigated to reduce the coating roughness. Different roughness values were achieved by varying the surface treatment processes. The laser based finishing enables a reduction of the Spk values by removing single roughness asperities. In order to identify the necessary process parameters for the laser treatment, an analytical model of the material removal was applied. The laser surface treatment achieved similar roughness characteristics compared to mechanical treatment. In this study the tribological behavior of a-C:H coated tools was analyzed under dry conditions within strip drawing tests. The tribological investigations revealed that for dry deep drawing of zinc coated DC04 a broader range of Spk values leads to acceptable tribological conditions whereas for AA5182 a smoother tool surface has to be ensured to prevent adhesion and utilize the full potential of a-C:H coatings