1. Articles from Rishi Puri

    1-13 of 13
    1. Diagnostic accuracy of 320-row computed tomography for characterizing coronary atherosclerotic plaques: Comparison with intravascular optical coherence tomography

      Diagnostic accuracy of 320-row computed tomography for characterizing coronary atherosclerotic plaques: Comparison with intravascular optical coherence tomography

      Background/Purpose. This study sought to determine the diagnostic accuracy of 320-row computed tomography (320CT) for characterizing coronary atherosclerotic plaques in comparison with optical coherence tomography (OCT). Methods/Materials. From 32 patients, 42 coronary segments were evaluated and co-registered by both 320CT and OCT. 320CT vulnerable plaque characteristics included low attenuation plaque (LAP) (<30HU), napkin-ring sign (NRS), positive remodeling (PR) and spotty calcification (SC). The presence of macrophage, neovascularization and cholesterol crystals was also determined by OCT. Results Minimal lumen area was 2.78 ± 1.23 mm by OCT and 3.29 ± 1.49 mm by 320CT ( p < 0.001 ...

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    2. Sex Differences in Nonculprit Coronary Plaque Microstructures on Frequency-Domain Optical Coherence Tomography in Acute Coronary Syndromes and Stable Coronary Artery Disease

      Sex Differences in Nonculprit Coronary Plaque Microstructures on Frequency-Domain Optical Coherence Tomography in Acute Coronary Syndromes and Stable Coronary Artery Disease

      Background— Numerous reports suggest sex-related differences in atherosclerosis. Frequency-domain optical coherence tomography has enabled visualization of plaque microstructures associated with disease instability. The prevalence of plaque microstructures between sexes has not been characterized. We investigated sex differences in plaque features in patients with coronary artery disease. Methods and Results— Nonculprit plaques on frequency-domain optical coherence tomography imaging were compared between men and women with either stable coronary artery disease (n=320) or acute coronary syndromes (n=115). A greater prevalence of cardiovascular risk factors was observed in women. Nonculprit plaques in women with stable coronary artery disease were more likely ...

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    3. Plaque Microstructures in Patients with Coronary Artery Disease who Achieved Very Low Low-Density Lipoprotein Cholesterol Levels

      Plaque Microstructures in Patients with Coronary Artery Disease who Achieved Very Low Low-Density Lipoprotein Cholesterol Levels

      Objective Lowering low-density lipoprotein cholesterol (LDL-C) with statins reduces cardiovascular events and slows plaque progression. While this therapeutic approach has been reported to favourably modify plaque composition, this is not well characterized in humans. Also, the benefit of achieving LDL-C levels below current recommended targets remains unknown. Frequency-domain optical coherence tomography (FD-OCT) enables visualization of plaque microstructures associated with plaque instability. We investigated plaque morphologies in patients with low LDL-C levels by using FD-OCT. Methods 293 and 122 non-obstructive lipid and fibrous plaques in 280 stable statin-treated CAD patients were evaluated by FD-OCT imaging in vessels requiring percutaneous coronary intervention ...

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      Mentions: E. Murat Tuzcu
    4. Plaque vulnerability at non-culprit lesions in obese patients with coronary artery disease: Frequency-domain optical coherence tomography analysis

      Plaque vulnerability at non-culprit lesions in obese patients with coronary artery disease: Frequency-domain optical coherence tomography analysis

      Background Obesity is associated with adverse atherosclerotic cardiovascular events. While various metabolic abnormalities associated with obesity promote plaque formation, the morphological phenotype of atherosclerotic plaque has not been well characterized in the setting of obesity. Frequency-domain optical coherence tomography (FD-OCT) enables in vivo visualization of plaque microstructures associated with vulnerability. We characterized plaque microstructures in obese patients. Methods FD-OCT imaging was performed in 308 patients with coronary artery disease undergoing percutaneous coronary intervention. Patients were stratified according to the presence or absence of obesity (body mass index > 30 kg/m 2 ). Plaques in obese ( n  = 129) and non-obese ( n  = 179 ...

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    5. Cholesterol Crystals Associate With Coronary Plaque Vulnerability In Vivo

      Cholesterol Crystals Associate With Coronary Plaque Vulnerability In Vivo

      The high local concentration of cholesterol in foam cells has been reported to formulate cholesterol crystals, which trigger a local inflammatory response ( 1 ). Intracellular crystals also induce apoptosis of foam cells, leading to further attraction of macrophages and development of a lipid-rich necrotic core 2 . These effects may suggest a potential contribution of cholesterol crystals to plaque destabilization. Frequency-domain optical coherence tomography (FD-OCT) enables visualization of cholesterol crystals in vivo ( 3 ). We investigated the impact of cholesterol crystals on plaque vulnerability in stable patients with coronary artery disease.

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    6. Spotty calcification and plaque vulnerability in vivo: frequency domain optical coherence tomography analysis

      Spotty calcification and plaque vulnerability in vivo: frequency domain optical coherence tomography analysis

      Background: Spotty calcification is a morphological characteristic of a vulnerable plaque phenotype. While this calcium pattern is considered an active process, promoted by inflammation, it is unknown whether spotty calcification associates with development of microstructures observed in vulnerable plaques. As frequencydomain optical coherence tomography (FD-OCT) enables visualization of microstructures associated with plaque vulnerability, we investigated the association between spotty calcification and plaque microstructures by using FD-OCT. Methods: A total of 300 patients with stable coronary artery disease (CAD), having clinical indication for percutaneous coronary intervention (PCI), were analyzed. Totally 280 non-culprit lipid plaques within the target vessel requiring PCI were ...

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    7. Frequency-Domain Optical Coherence Tomographic Analysis of Plaque Microstructures at Non-culprit Narrowings in Patients Receiving Potent Statin Therapy

      Frequency-Domain Optical Coherence Tomographic Analysis of Plaque Microstructures at Non-culprit Narrowings in Patients Receiving Potent Statin Therapy

      Potent statin therapy has been demonstrated to reduce cardiovascular events. While statins have been considered to stabilize atherosclerotic plaque, this effect has not been well characterized in vivo. We investigated the relationship between potent statin therapy and plaque microstructures imaged by frequency-domain optical coherence tomography (FD-OCT). 290 non-culprit lipid plaques in 275 patients with stable coronary artery disease receiving atorvastatin or rosuvastatin were analyzed. Patients were stratified into no statin, low- and high-dose statin group. Plaques in the high-dose statin group demonstrated a smaller lipid arc (p=0.02) and a greater fibrous cap thickness (p=0.01). In patients ...

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    8. The impact of lumen size and microvascular resistance on Fourier-domain optical coherence tomography (FD-OCT) coronary measurements

      The impact of lumen size and microvascular resistance on Fourier-domain optical coherence tomography (FD-OCT) coronary measurements

      Fourier-domain optical coherence tomography (FD-OCT) is a catheter based intravascular imaging modality providing high-resolution images of the coronary lumen. During image acquisition, angiographic contrast media is injected via an infusion pump to achieve effective intracoronary clearance of blood for optimal image acquisition. The influence of shear stress on FD-OCT images and subsequent measurement analysis has a potential to vary at differing macro- and microvascular conditions .

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    9. Intracoronary Optical Coherence Tomography-Are We Getting Too Close To The Light?

      Intracoronary Optical Coherence Tomography-Are We Getting Too Close To The Light?

      At school we all learned of the tale from Greek mythology of Icarus, who while trying to escape from Crete ignored the warnings of his father and flew too close to the sun. His wings of feather and wax melted and he fell to the sea, where he drowned. This tale is often told as a warning of the perils of overambition. It is ironic how our desire to advance new approaches in cardiovascular medicine so commonly reaches a similarly futile outcome. One such area that continues to stimulate our desire to push the boundaries is the ability to visualize .

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      Mentions: Cleveland Clinic
    10. Exploring coronary atherosclerosis with intravascular imaging

      Exploring coronary atherosclerosis with intravascular imaging

      Coronary angiography has been widely used for five decades to evaluate a range of vascular pathologies and triage patients to therapeutic interventions. The inability to directly visualize the artery wall with conventional angiographic techniques has stimulated development of a number of intravascular imaging modalities. These approaches have the potential to provide a more comprehensive characterization of the burden, composition and functionality of atherosclerotic plaque, neointimal hyperplasia and allograft vasculopathy that develop within coronary arteries. The ability to use these modalities in vivo and in a serial fashion has provided a greater insight into the factors that underlie the disease process ...

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    11. Suspected hypersensitivity reaction following drug-eluting stent implantation: novel insights with optical coherence tomography

      Suspected hypersensitivity reaction following drug-eluting stent implantation: novel insights with optical coherence tomography

      A 66-year-old woman who previously underwent coronary artery bypass surgery was admitted due to anginal symptoms. Coronary angiography (CAG) revealed a severe stenosis of the right coronary artery at the anastomotic site of a saphenous vein graft (SVG) and a residual stenosis of the posterior descending artery (PDA) (Figure 1A). Paclitaxel-eluting stents (Taxus, Boston Scientific, Natick, Massachusetts) were implanted for these lesions (Figure 1B). However, she developed angina recurrence 6 months after stent implantation. CAG showed in-stent restenosis (ISR) at the proximal edge of the Taxus stent within the mid-PDA lesion (Figure 2A). A sirolimus-eluting stent (Cypher, Cordis, Johnson and ...

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    1-13 of 13
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    1. (7 articles) E. Murat Tuzcu
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    Suspected hypersensitivity reaction following drug-eluting stent implantation: novel insights with optical coherence tomography Exploring coronary atherosclerosis with intravascular imaging Intracoronary Optical Coherence Tomography-Are We Getting Too Close To The Light? The impact of lumen size and microvascular resistance on Fourier-domain optical coherence tomography (FD-OCT) coronary measurements Frequency-Domain Optical Coherence Tomographic Analysis of Plaque Microstructures at Non-culprit Narrowings in Patients Receiving Potent Statin Therapy Spotty calcification and plaque vulnerability in vivo: frequency domain optical coherence tomography analysis Cholesterol Crystals Associate With Coronary Plaque Vulnerability In Vivo Plaque vulnerability at non-culprit lesions in obese patients with coronary artery disease: Frequency-domain optical coherence tomography analysis Plaque Microstructures in Patients with Coronary Artery Disease who Achieved Very Low Low-Density Lipoprotein Cholesterol Levels Sex Differences in Nonculprit Coronary Plaque Microstructures on Frequency-Domain Optical Coherence Tomography in Acute Coronary Syndromes and Stable Coronary Artery Disease Duke University Engineering Professor Sina Farsiu Elected Fellow of the IEEE PhotoniCare Takes First Place at the 2019 HealthTECH Startup Competition