1. Articles from Kyoichi Mizuno

    1-24 of 41 1 2 »
    1. Relation of Low-Density Lipoprotein Cholesterol Level to Plaque Rupture

      Relation of Low-Density Lipoprotein Cholesterol Level to Plaque Rupture

      Statin therapy reduces low-density lipoprotein cholesterol (LDL-C), inflammation, and atherosclerotic cardiovascular disease. We investigated the association between LDL-C and statin therapy on the prevalence of plaque rupture (PR). Patients with acute coronary syndromes who underwent optical coherence tomography imaging of the culprit lesion were divided into 4 groups based on LDL-C level and statin use (Group 1: LDL-C ≤ 100 without statin; Group 2; LDL-C ≤ 100 with statin; Group 3: LDL-C >100 with statin; Group 4: LDL-C >100 without statin), and the prevalence of PR was compared between the groups. Among 896 patients, PR was diagnosed in 444 (49.6%) patients ...

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    2. Degree of luminal narrowing and composition of thrombus in plaque erosion

      Degree of luminal narrowing and composition of thrombus in plaque erosion

      As the degree of luminal narrowing increases, shear stress increases, and high shear stress is known to activate platelets. However, the relationship between the degree of luminal narrowing and the composition of thrombus in patients with plaque erosion has not been studied. A total of 148 patients with plaque erosion and thrombus detected by optical coherence tomography were divided into tertiles based on the minimum lumen area (MLA) at the culprit lesion. Thrombus was categorized as platelet-rich or fibrin-rich. Among 148 patients, 50 (34%) were in the mild stenosis group, 49 (33%) were in the moderate stenosis group, and 49 ...

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    3. Comparison of post‐stent optical coherence tomography findings: Layered versus non‐layered culprit lesions

      Comparison of post‐stent optical coherence tomography findings: Layered versus non‐layered culprit lesions

      Objectives This study aimed to investigate the vascular response of lesions with a layered phenotype. Background Recent studies have shown that layered plaques at culprit lesions detected by optical coherence tomography (OCT) have greater plaque burden and more inflammatory features than non‐layered plaques. Methods This is a retrospective observational study. A total of 193 target lesions from 193 patients [100 patients with acute coronary syndromes (ACS) and 93 with stable angina pectoris (SAP)] who had undergone OCT imaging of the culprit lesion both before and after stenting were included. Layered plaques were identified by OCT as plaques with layers ...

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    4. Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Background Lipid-rich plaque (LRP) is thought to be a precursor to cardiac events. However, its clinical significance in coronary arteries has never been systematically investigated. Objectives This study investigated the prevalence and clinical significance of LRP in the nonculprit region of the target vessel in patients undergoing percutaneous coronary intervention (PCI). Methods The study included 1,474 patients from 20 sites across 6 countries undergoing PCI, who had optical coherence tomography (OCT) imaging of the target vessel. Major adverse cardiac events (MACE) were defined as a composite of cardiac death, acute myocardial infarction, and ischemia-driven revascularization. Patients were followed for ...

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    5. Target lesion evaluation by multiple modalities in vivo: near-infrared spectroscopy (NIRS), virtual histology intravascular ultrasound, optical coherence tomography, and angioscopy

      Target lesion evaluation by multiple modalities in vivo: near-infrared spectroscopy (NIRS), virtual histology intravascular ultrasound, optical coherence tomography, and angioscopy

      A 60-year-old man presented with ischaemic heart failure. We conducted coronary angiography (CAG) after improvement of the heart failure. On CAG, there was a hazy stenosis in the proximal left anterior descending artery (Figure 1, Moving image 1) . The lesion was observed by four modalities: near-infrared spectroscopy (NIRS), virtual histology intravascular ultrasound (VH-IVUS), optical coherence tomography (OCT), and angioscopy. NIRS detected lipid core plaque with echolucency on greyscale IVUS. VH-IVUS showed necrotic core plaque (Figure 1, Moving image 1) . OCT showed lipid-rich plaque, and angioscopy showed yellow intima (Figure 1, Moving image 1) . All modalities could detect lipid content and ...

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    6. The Role of Multiple Imaging Modalities to Disclose the Mechanism of ACS Angioscopy in Comparison to Other Imaging Modalities Including OCT, IVUS and CTA (Book Chapter)

      The Role of Multiple Imaging Modalities to Disclose the Mechanism of ACS Angioscopy in Comparison to Other Imaging Modalities Including OCT, IVUS and CTA (Book Chapter)

      This book presents a thorough review of coronary angioscopy, ranging from instructions on its use to the latest advances. Starting with the structure and fundamental principles of angioscopy, it shows readers how to apply the image to comprehensive care of coronary-artery patients. Plentiful color photos and illustrations will enable readers to investigate and classify plaques and thrombi and to evaluate coronary stent- and drug-based therapies. The authors are leading researchers on angioscopy. This book offers the perfect guide not only for new clinicians but also for cardiologists who have already adopted this technique for medical examination and treatment. Angioscopy is ...

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    7. Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT

      Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT

      Even in the drug-eluting stent era, diabetes mellitus (DM) patients have high incidences of restenosis and repeat revascularization after percutaneous coronary intervention. The aim of this study was to compare vascular response after stent implantation between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) by using optical coherence tomography (OCT) in DM patients as well as in non-DM patients. In the Japan-Drug Eluting Stents Evaluation; a Randomized Trial (J-DESsERT), the OCT sub-study enrolled 75 patients who underwent 8 months follow-up imaging after SES or PES implantation. Mean neointimal hyperplasia (NIH) thickness was significantly thinner in SES than PES in the DM ...

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    8. Relationship between cholesterol crystals and culprit lesion characteristics in patients with stable coronary artery disease: an optical coherence tomography study

      Relationship between cholesterol crystals and culprit lesion characteristics in patients with stable coronary artery disease: an optical coherence tomography study

      Aims Some recent studies have reported the role of cholesterol crystals (ChCs) in plaque rupture in patients with coronary artery disease. We used optical coherence tomography (OCT) to investigate the characteristics of coronary plaques that were associated with derived ChCs. Methods We evaluated 101 subjects with stable coronary artery disease who underwent OCT. We compared the OCT findings of the culprit lesions with ChCs to those without ChCs and investigated the background characteristics. Results ChCs were observed in culprit lesions of 39 patients. The frequencies of spotty calcification, microchannel structure, and lipid-rich plaque were significantly higher in patients with ChCs ...

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    9. Feature Of The Week 8/4/13: MGH OCT Registry Reports on In Vivo OCT Studies of Plaque Erosion and Calcified Nodule In Acute Coronary Syndrome

      Feature Of The Week 8/4/13: MGH OCT Registry Reports on In Vivo OCT Studies of Plaque Erosion and Calcified Nodule In Acute Coronary Syndrome

      Pathology studies reported that three most common causes of acute coronary syndrome (ACS) or sudden cardiac death are plaque rupture, plaque erosion and calcified nodules. The morphological and clinical characteristics of the underlying pathology of ACS, especially plaque erosion and calcified nodule, have never been well studied in vivo. Using optical coherence tomography, we found that plaque erosions are the substrate for ACS in 31% of patients and calcified nodules in 8% of patients, which are consistent with pathological findings. Erosions are more likely to cause non-ST-segment elevation ACS than ST-segment elevation myocardial infarction. Compared to plaque rupture, plaque erosion ...

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    10. In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients with Acute Coronary Syndrome by Intravascular Optical Coherence Tomography

      In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients with Acute Coronary Syndrome by Intravascular Optical Coherence Tomography

      Objectives To characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo . Methods One hundred and twenty-six patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or others using a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the ...

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    11. Nonculprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Nonculprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Background— Chronic kidney disease (CKD) promotes the development of atherosclerosis and increases the risk of cardiovascular disease. The aim of the present study was to compare the coronary plaque characteristics of patients with and without CKD using optical coherence tomography. Methods and Results— We identified 463 nonculprit plaques from 287 patients from the Massachusetts General Hospital (MGH) optical coherence tomography registry. CKD was defined as estimated glomerular filtration rate <60 mL/min per 1.73 m 2 . A total of 402 plaques (250 patients) were in the non-CKD group and 61 plaques (37 patients) were in the CKD group. Compared ...

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    12. Identification of high-risk plaques associated with peri-procedural myocardial injury following elective percutaneous coronary intervention: Assessment by high-sensitivity troponin-T measurements and optical coherence tomography

      Identification of high-risk plaques associated with peri-procedural myocardial injury following elective percutaneous coronary intervention: Assessment by high-sensitivity troponin-T measurements and optical coherence tomography

      A worse prognosis of peri-procedural myocardial injury (PMI) following percutaneous coronary intervention (PCI) has been reported in patients displaying an isolated elevation of cardiac troponin-T (TnT) or troponin-I . Highly sensitive assay for TnT (hs-TnT) is newly developed, permitting measurement of TnT than those measurable limit with conventional assays . Thus, procedural changes in TnT values following PCI using the hs-TnT assay may identify more minute myocardial injury. Optical coherence tomography (OCT) with high-resolution images (≈15μm) allows detailed information such as fibrous cap thickness, and lipid distribution of the atherosclerotic plaque in vivo . Therefore, this study has focused on precise assessments ...

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    13. Soluble lectin-like oxidized LDL receptor-1 (sLOX-1) as a valuable diagnostic marker for rupture of thin-cap fibroatheroma: Verification by optical coherence tomography

      Soluble lectin-like oxidized LDL receptor-1 (sLOX-1) as a valuable diagnostic marker for rupture of thin-cap fibroatheroma: Verification by optical coherence tomography

      Background Relationships between plaque morphology on optical coherence tomography (OCT) and biomarker levels in the patients with acute coronary syndrome (ACS) have not been fully investigated. Methods ACS patients (n = 128) were prospectively enrolled and their plasma levels of soluble lectin-like oxidized LDL receptor-1 (sLOX-1), high-sensitivity C-reactive protein (hs-CRP), and high-sensitivity troponin T (hs-TnT) were measured. Another set of 20 patients with stable angina pectoris (SAP) without plaque rupture or erosion served as controls. Among 128 ACS patients, 75 patients underwent OCT procedure to evaluate culprit plaque morphology, and were categorized into two groups; ACS with plaque rupture (ruptured ACS ...

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    14. Deceived incidence of acute coronary syndrome by measurement of FFR: Diagnostic gap of vulnerable plaque between physiology and morphology

      Deceived incidence of acute coronary syndrome by measurement of FFR: Diagnostic gap of vulnerable plaque between physiology and morphology

      A 67-year-old male was admitted because of acute myocardial infarction (AMI). An emergent coronary angiography showed a total occlusion in the left anterior descending artery, and a stent was deployed. Moderate lesion stenosis was found in the right coronary artery (RCA). Fractional flow reserve indicated 0.96, and percutaneous coronary intervention was not performed. Six months later, the patient visited an emergency room due to AMI. Angiograms showed a patency of the previous stent and progressed stenosis with filling delay of the RCA. Protruding red thrombi and plaque disruption of thin-cap fibroatheroma (TCFA) were identified by optical coherence tomography. Mild ...

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    15. Non-Culprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Non-Culprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Background —Chronic kidney disease (CKD) promotes the development of atherosclerosis and increases the risk of cardiovascular disease. The aim of the present study was to compare the coronary plaque characteristics of patients with and without CKD using optical coherence tomography (OCT). Methods and Results —We identified 463 non-culprit plaques from 287 patients from the MGH OCT Registry. CKD was defined as estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m 2 . 402 plaques (250 patients) were in the non-CKD group and 61 plaques (37 patients) were in the CKD group. Compared to non-CKD plaques, plaques with CKD had a larger ...

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    16. Comparison of Nonculprit Coronary Plaque Characteristics Between Patients With and Without Diabetes : A 3-Vessel Optical Coherence Tomography Study

      Comparison of Nonculprit Coronary Plaque Characteristics Between Patients With and Without Diabetes : A 3-Vessel Optical Coherence Tomography Study

      Objectives The aim of the present study was to compare the characteristics of nonculprit coronary plaques between diabetes mellitus (DM) and non-DM patients using 3-vessel optical coherence tomography (OCT) imaging. Background DM patients have a higher recurrent cardiovascular event rate. Methods Patients who had undergone 3-vessel OCT imaging were identified from the Massachusetts General Hospital OCT Registry. Characteristics of nonculprit plaques were compared between DM and non-DM patients. Results A total of 230 nonculprit plaques were identified in 98 patients. Compared with non-DM patients, DM patients had a larger lipid index (LI) (averaged lipid arc × lipid length; 778.6 ± 596 ...

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    17. Acute coronary syndrome without optical coherence tomography identification of plaque disruption: Is this plaque erosion?

      Acute coronary syndrome without optical coherence tomography identification of plaque disruption: Is this plaque erosion?

      A 42-year-old female with a history of hypercholesterolemia was admitted to our hospital due to anterior ST-elevation myocardial infarction (STEMI). She was a non-smoker and her chest pain appeared during exercise. Emergent coronary angiograms showed filling defects and total occlusion in the proximal left anterior descending artery (LAD). Following diagnostic angiography, thrombectomy was performed. After aspiration of intracoronary thrombi, filling defects disappeared and revascularization of the LAD was obtained, though persistent distal embolization was confirmed (). Intravascular optical coherence tomography (OCT) observations of the culprit vessel showed lipid plaques with high attenuation, and small residual thrombi. However, obvious atherosclerotic plaque disruption ...

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    18. Clear view, clear benefit (editorial)

      Clear view, clear benefit (editorial)

      In this issue of the Journal, a clinical investigation by Ozaki et al focuses on the flushing solution used for image acquisition with frequency-domain optical coherence tomography (FD-OCT). 1 The authors present the cross-sectional area measurement as a quantitative evaluation using low-molecular dextran L (LMD-L) approximate to that of contrast media, and the non-inferiority of LMD-L to contrast media with regard to FD-OCT image quality. Although the cross-sectional and longitudinal images of OCT are analogous with those of intravascular ultrasound (IVUS), the image resolution of OCT is extremely high ( ≈10– 20 μm), which is more than 10-fold that of IVUS ...

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    19. Nonculprit Plaques in Patients With Acute Coronary Syndromes Have More Vulnerable Features Compared With Those With Non–Acute Coronary Syndromes: A 3-Vessel Optical Coherence Tomography Study

      Nonculprit Plaques in Patients With Acute Coronary Syndromes Have More Vulnerable Features Compared With Those With Non–Acute Coronary Syndromes: A 3-Vessel Optical Coherence Tomography Study

      Background—Patients with acute coronary syndrome (ACS) have a higher incidence of recurrent ischemic events. The aim of this study was to compare the plaque characteristics of non-culprit lesions between ACS and non-ACS patients using optical coherence tomography (OCT) imaging. Methods and Results—Patients who had 3-vessel OCT imaging were selected from the Massachusetts General Hospital (MGH) OCT Registry. MGH registry is a multicenter registry of patients undergoing OCT. The prevalence and characteristics of non-culprit plaques were compared between ACS and non-ACS patients. A total of 248 non-culprit plaques were found in 104 patients: 45 plaques in 17 ACS patients ...

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    20. Intracoronary Imaging Modalities for Vulnerable Plaques

      Intracoronary Imaging Modalities for Vulnerable Plaques

      The concept of vulnerable plaque (VP) has been widely accepted as the primary cause of acute coronary syndrome (ACS) and sudden cardiac death. ACS is thought to result fromsudden disruption of a VP with subsequent occlusive thrombosis. VP typically consists of several components; a large necrotic core, thin fibrous cap, increase in macrophage activity,increase in vaso vasorum, and positive remodeling.In recent years, invasive or non-invasive diagnostic imaging modalities have beendeveloped for indentifying VP. VP has been recognized in various modalities not only byvisualization of cross sectional images by high-resolution imaging modalities, such as virtualhistology intravascular ultrasound (VH-IVUS), integrated ...

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    21. Natural History of a Thin-Cap Fibroatheroma: Serial Observations by Optical Coherence Tomography

      Natural History of a Thin-Cap Fibroatheroma: Serial Observations by Optical Coherence Tomography
      Disruption of thin-cap fibroatheromas (TCFAs) is an initial cause of fatal acute coronary syndrome according to fragmentary investigations of pathology.1 Postcardiac event observations using recent intracoronary imaging devices support that TCFAs are equivalent to vulnerable plaques.2,3 However, to our knowledge, no serial documentation of plaque disruption has yet been performed in living patients. A 69-year-old man with stable angina underwent successful drug-eluting stent implantation in the left anterior descending coronary artery. He was receiving medical therapies for hypertension and dyslipidemia. His fasting serum total cholesterol, triglycerides, and high-density lipoprotein cholesterol were 230 mg/dL, 649 mg/dL ...
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    22. Six-month follow-up evaluation for everolimus-eluting stents by intracoronary optical coherence tomography: Comparison with paclitaxel-eluting stents

      Six-month follow-up evaluation for everolimus-eluting stents by intracoronary optical coherence tomography: Comparison with paclitaxel-eluting stents
      Background Although several clinical trials have shown the superior efficacy and safety of second-generation everolimus-eluting stents (EES) in comparison with first-generation paclitaxel-eluting stents (PES), the differences in the vascular healing process between EES and PES in a human coronary artery during an early stage are unknown. Methods A prospective optical coherence tomography (OCT) observation was performed for 25 EES in 21 patients and 27 PES in 21 patients at 6months after implantation. Cross-sections within single-stent segments were analyzed at intervals of 1mm. The neointimal (NI) thickness on each strut was measured. Uncovered struts (NI thickness=0μm), malapposed struts, NI area ...
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    23. Current status of optical coherence tomography

      Current status of optical coherence tomography
      Optical coherence tomography (OCT) is a novel imaging technology based on low-coherence interferometry that use near-infrared light in real-time, and allows cross-sectional in-situ visualization of the vessel wall at the microscopic level. OCT provides 10-fold higher resolution than intravascular ultrasound which is currently the most used modality for intra-coronary imaging. OCT offers the obvious advantages when characterizing precise plaque microstructure and distinguishing various type of plaques. OCT is also being assessed for its potential role in the understanding of neointimal coverage, vascular healing and the progression of atherosclerosis in coronary vasculature after stenting on the micron scale. These unique capabilities ...
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    1-24 of 41 1 2 »
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    1. (41 articles) Kyoichi Mizuno
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