1. Articles in category: Cardiology

    1-24 of 4369 1 2 3 4 ... 180 181 182 »
    1. Comparison of optical coherence tomography-guided versus intravascular ultrasound-guided percutaneous coronary intervention: Rationale and Design of a Randomized, controlled OCTIVUS trial

      Comparison of optical coherence tomography-guided versus intravascular ultrasound-guided percutaneous coronary intervention: Rationale and Design of a Randomized, controlled OCTIVUS trial

      The clinical value of intracoronary imaging for percutaneous coronary intervention (PCI) guidance is well acknowledged. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are the most common use for intravascular imaging to guide and optimize PCI in day-to-day practice. However, the comparative effectiveness of IVUS-guided and OCT-guided PCI with respect to clinical end points remains unknown. Methods and Design The OCTIVUS study is a prospective, multicenter, open-label, parallel-arm, randomized trial comparing the effectiveness of two imaging-guided strategies in patients with stable angina or acute coronary syndromes undergoing PCI in Korea. A total of 2000 patients are randomly assigned in a ...

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    2. OCT Reveals Biomechanics of a Developing Mouse Heart, Live in 4D

      OCT Reveals Biomechanics of a Developing Mouse Heart, Live in 4D

      Scientists from Stevens Institute of Technology and Baylor College of Medicine used 4D optical coherence tomography (OCT) to study the pumping mechanism underlying the developing mammalian heart. 4D OCT allowed them to investigate the functional relation between blood flow and heart wall dynamics within different regions of the embryonic heart at a level of detail not currently accessible by other methods. 4D OCT could potentially enable scientists to assess cardiac pumping over embryonic development as the heart tube remodels, which could reveal functional changes during early cardiogenesis that lead to congenital heart defects. The researchers used 4D OCT to obtain ...

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    3. Prevalence and quantitative assessment of macrophages in coronary plaques

      Prevalence and quantitative assessment of macrophages in coronary plaques

      Although optical coherence tomography (OCT) proved to be able to identify macrophage clusters, there are no available data on the possibility to obtain reproducible measurements of their circumferential extension and location. The purpose of the present post-hoc analysis of the CLIMA study was to revise the clinical and demographic variables of patients having coronary plaques with macrophages and to investigate the reproducibility of their quantitative assessment. A total of 577 patients out of 1003 undergoing OCT showed macrophage accumulation. Three groups were identified; group 1 (426 patients) without macrophages, group 2 (296) patients with low macrophage content (less than median ...

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    4. Validation and application of OCT tissue attenuation index for the detection of neointimal foam cells

      Validation and application of OCT tissue attenuation index for the detection of neointimal foam cells

      Neointimal infiltration with foamy macrophages is recognized as an early and important sign of de-novo atherosclerosis after stent implantation (neoatherosclerosis). Recent histopathological studies have proven that automated quantification of signal attenuation using intravascular optical coherence tomography (OCT) imaging allows for sensitive identification of macrophages in native atherosclerotic disease. Whether this is true for neointimal foam cells in the setting of neoatherosclerosis remains unknown. Autopsy samples of stented coronary arteries (n = 13 cases) were evaluated by histology and OCT. After co-registration with histology, the attenuation rate of emitted laser light was measured in regions with and without neointimal foamy macrophages relative ...

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    5. Live mechanistic assessment of localized cardiac pumping in mammalian tubular embryonic heart

      Live mechanistic assessment of localized cardiac pumping in mammalian tubular embryonic heart

      Significance: Understanding how the valveless embryonic heart pumps blood is essential to elucidate biomechanical cues regulating cardiogenesis, which is important for the advancement of congenital heart defects research. However, methods capable of embryonic cardiac pumping analysis remain limited, and assessing this highly dynamic process in mammalian embryos is challenging. New approaches are critically needed to address this hurdle. Aim: We report an imaging-based approach for functional assessment of localized pumping dynamics in the early tubular embryonic mouse heart. Approach: Four-dimensional optical coherence tomography was used to obtain structural and Doppler hemodynamic imaging of the beating heart in live mouse embryos ...

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    6. Dynamic Imaging of Mouse Embryos and Cardiac Development in Static Culture

      Dynamic Imaging of Mouse Embryos and Cardiac Development in Static Culture

      Dynamic imaging is a powerful approach to assess the function of a developing organ system. The heart is a dynamic organ that undergoes quick morphological and mechanical changes through early embryonic development. Defining the embyonic mouse heart's normal function is important for our own understanding of human heart development and will inform us on treatments and prevention of congenital heart defects (CHD). Traditional methods such as ultrasound or fluorescence-based microscopy are suitable for live dynamic imaging, are excellent to visualize structure and connect gene expression to phenotypes, but can be of low quality in resolving fine features and lack ...

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    7. Innovative method offers a new way of studying developmental cardiac biomechanics, live in 4-D

      Innovative method offers a new way of studying developmental cardiac biomechanics, live in 4-D

      How a valveless embryonic heart tube pumps blood is a long-standing scientific mystery. Thanks to innovations in light-based technology, fresh insights are now available into the biomechanics of mammalian cardiogenesis—and in particular, the pumping dynamics of the mammalian tubular embryonic heart.

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    8. Plaque mOrphology iMpact on Side Branch Occlusion at oPtical Coherence Tomography Evaluation in Percutaneous Coronary Interventions

      Plaque mOrphology iMpact on Side Branch Occlusion at oPtical Coherence Tomography Evaluation in Percutaneous Coronary Interventions

      Despite recent advances in interventional cardiology, bifurcation coronary artery stenoses (which account for 15-20% of all coronary lesions treated by PCI), remain a challenge for PCI operators with higher rates of failure, in-stent restenosis, stent thrombosis, and recurrent clinical events, when compared to simple non-bifurcation lesions. POMPEI trial is a prospective observational study. We aim to investigate the impact of morphological plaque characteristics assessed by optical coherence tomography (OCT) on the risk of developing side branch occlusion (SBO) in bifurcation PCI. A total of 27 patients undergoing bifurcation PCI will be recruited into the trial. PCI will be performed according ...

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    9. Progressive growth of coronary aneurysms after bioresorbable vascular scaffold implantation: Successful treatment with OCT‐guided exclusion using covered stents

      Progressive growth of coronary aneurysms after bioresorbable vascular scaffold implantation: Successful treatment with OCT‐guided exclusion using covered stents

      The development and progressive enlargement over time of multiple saccular coronary artery aneurysms (CAA) after implantation of everolimus‐eluting stent and bioresorbable vascular scaffolds (BVS) have been reported. CAA was successfully excluded by two overlapped covered stents expanded inside a long metallic drug‐eluting stent to avoid dislodgment at the overlap point. Optical coherence tomography (OCT) was repeatedly performed to monitor CAA expansion and to guide treatment through precise measurement of aneurysm length and vessel size at the landing zone. At 10‐month follow‐up, coronary computed tomography angiography showed persistent CAA exclusion. To the best of our knowledge, this ...

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    10. Diagnosis of Intraplaque Hemorrhage by High-Definition Intravascular Ultrasound and Optical Coherence Tomography

      Diagnosis of Intraplaque Hemorrhage by High-Definition Intravascular Ultrasound and Optical Coherence Tomography

      A 67-year-old woman, a heavy smoker and with hypothyroidism, presented with a non–STsegment elevation myocardial infarction with negative T waves on the inferior leads. Coronary angiography revealed a focal stenosis in the mid right coronary artery (arrow in Figure 1A) but no other coronary lesions. High-definition (60-MHz) intravascular ultrasound (IVUS) (ACIST Medical Systems, Eden Prairie, Minnesota) revealed a large hyperechoic noncalcific plaque encompassing a well-delineated, crescent-shaped area showing a striking hypoechogenicity (echolucent “black” area) (yellow asterisks in Figures 1B and 1C [white asterisk denotes wire artifact]). The immediately adjacent plaque had a more reflective pattern with marked speckling (Figures ...

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    11. The frequency and clinical characteristics of in-stent restenosis due to calcified nodule development after coronary stent implantation

      The frequency and clinical characteristics of in-stent restenosis due to calcified nodule development after coronary stent implantation

      The purpose of this study was to evaluated the clinical characteristics of calcified nodule-like in-stent restenosis (ISR) lesions using optical coherence tomography (OCT) in vivo. A total of 124 ISR lesions that were treated with a repeat coronary intervention under OCT guidance were included in this analysis. ISR neointimal morphology was classified as “calcified nodule-like ISR”, that appeared as a high-backscattering protruding mass with an irregular surface covered by signal-rich bands, or “non-calcified nodule-like ISR”. The maximum arc and thickness of calcium behind the stent struts was also measured. Of the 124 ISR lesions, calcified nodule-like ISR was observed in ...

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      Mentions: Kenichi Fujii
    12. Idiopathic ventricular fibrillation or myocardial infarction? Impact of optical coherence tomography on therapeutic decisions

      Idiopathic ventricular fibrillation or myocardial infarction? Impact of optical coherence tomography on therapeutic decisions

      A female patient (47 years old) was referred from a district hospital for Implantable Cardioverter-Defibrillator (ICD) insertion as secondary prevention. Cardiac arrest occurred one week earlier in the course of ventricular fibrillation with an effective defibrillation. It was preceded by the chest pain. ECG showed elevation of ST-segment in inferior leads. Coronary angiography exam did not show stenosis of coronary vessels (Fig. 1A, 1B, 1C). Her medical history revealed mitral and tricuspid valve surgery related to insufficiency 10 years before. No risk factors of ischemic heart disease. While hospitalized she underwent echocardiography, which found akinesis of the basal inferior wall ...

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    13. https://doi.org/10.1093/eurheartj/ehaa632

      https://doi.org/10.1093/eurheartj/ehaa632

      A 56-year-old man with stable angina pectoris underwent implantation of a 3.5 mm × 28-mm Absorb bioresorbable vascular scaffold (BVS; Abbott Vascular, Santa Clara, CA, USA) in the left anterior descending coronary artery ( Panels A and B ). Optical coherence tomography (OCT) before ( Panel E ) and after implantation ( Panel F ) showed significant signal attenuation at the culprit site suggesting lipid-rich plaque, and fully apposed BVS struts ( Panel F and Supplementary material online , Video S1 ). Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel continued for a year, followed by aspirin monotherapy. Follow-up angiography after 2 years showed a patent, scaffolded segment...

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    14. Rediscover a Missed Culprit Lesion with Optical Coherence Tomography in Acute Coronary Syndrome: a Simple Stationary Pullback Method

      Rediscover a Missed Culprit Lesion with Optical Coherence Tomography in Acute Coronary Syndrome: a Simple Stationary Pullback Method

      A 54-year-old male was admitted to the hospital due to severe chest pain. He suffered from diabetes mellitus for 20 years and was an ex-smoker. The 12 leads electrocardiography showed ST-segment elevation in inferior leads. High sensitivity troponin level was elevated, and underwent coronary angiography. The echocardiogram showed basal inferior hypokinesia with normal left ventricular systolic function. The coronary angiography demonstrated an insignificant stenosis with vague plaque ulceration at the proximal portion of right coronary artery ( Figure 1A , asterisk). The automatic motorized pullback of optical coherence tomography (OCT) was performed at 10 mm/sec with simultaneous injection of a contrast ...

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    15. Z-shape phenomenon of optical coherence tomography catheter: potential cause of coronary perforation

      Z-shape phenomenon of optical coherence tomography catheter: potential cause of coronary perforation

      A 75-year-old female underwent coronary intervention with rotational atherectomy (RA) due to severely calcified lesions in the left anterior descending artery (Panel A , yellow arrows). After RA with a 1.5 mm burr, multiple cracks were successfully created without any complications (Panel B ). To optimize stent deployment in the calcified lesion, we attempted to use optical coherence tomography (OCT). Despite effective lesion modification and support of a guide extension catheter, an OCT catheter (Dragonfly OPTIS, Abbott Vascular, Santa Clara, CA, USA) could not advance through the lesion with its lens part bent toward a side branch (Panel C , a white ...

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    16. Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography

      Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography

      Objectives . The aim of this study is to assess the utility of optical coherence tomography (OCT) in patients with exercise-related acute coronary syndrome (ACS) presenting with inconclusive angiographic findings. Background . Regular physical activity reduces the incidence of cardiovascular events. Nevertheless, the risk of ACS or sudden cardiac death (SCD) increases during sport. In adults older than 35 years, exercise-related ACS or SCD is associated with plaque rupture, but not infrequently patients present ambiguous angiographic findings. Methods . Between September 2015 and January 2020, patients admitted for ACS or SCD triggered by physical exertion and with coronary stenosis ≤50% were included in ...

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    17. Prognostic impact of healed coronary plaque in non-culprit lesions assessed by optical coherence tomography

      Prognostic impact of healed coronary plaque in non-culprit lesions assessed by optical coherence tomography

      Background and Aims We sought to investigate the characteristics and prognostic impact of healed plaque (HP) detected by optical coherence tomography (OCT) in non-culprit segments in treated vessels. Methods OCT analysis included HP having a different optical intensity with clear demarcation from underlying plaque, thin-cap fibroatheroma (TCFA), and minimal lumen area. Non-culprit lesion (NCL) was defined as a plaque with >90º arc of disease (≥0.5mm intimal thickness), length ≥2 mm, and location >5 mm from the stent edges. Major adverse cardiac event (MACE) included cardiac death, myocardial infarction (MI), or ischemia-driven revascularization (IDR). Results We studied a total of ...

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    18. Unexpected Findings and Tailored Treatments of In-Stent Restenosis: Novel Insights from Optical Coherence Tomography

      Unexpected Findings and Tailored Treatments of In-Stent Restenosis: Novel Insights from Optical Coherence Tomography

      A 68-year-old man was admitted to our hospital with unstable angina. His medical history was remarkable for an acute myocardial infarction one year ago, treated with a zotarolimus-eluting stent (3.5×30 mm) in the mid right coronary artery. Coronary angiography showed a diffused in-stent restenosis (ISR) with haziness and filling defects (Figure 1A, Video 1). In order to identify the underlying mechanisms of ISR, optical coherence tomography (OCT) was performed due to its high resolution. OCT showed a large, recanalized thrombus with multiple channels divided by thin septa (longitudinal view and Figure 1C-1E) in the setting of an undersized ...

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    19. Assessment of the conventional radial artery with optical coherent tomography after the snuffbox approach

      Assessment of the conventional radial artery with optical coherent tomography after the snuffbox approach

      Background: This study aimed to evaluate acute injuries of the radial artery (RA) using optical coherence tomography (OCT) in patients who underwent coronary intervention via the snuffbox approach. Methods: Forty-six patients, who underwent coronary intervention and assessment of the conventional RA using OCT via the snuffbox approach, were enrolled from two university hospitals between August 2018 and August 2019. Results: The mean age of the patients was 65.1 years. In this study population, 6-French (Fr) sheaths were used. The mean diameter of the conventional RA was 2.89 ± 0.33 mm, and the mean lumen area of the conventional ...

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    20. Atherosclerotic Plaque Tissue Characterization: An OCT-Based Machine Learning Algorithm With ex vivo Validation

      Atherosclerotic Plaque Tissue Characterization: An OCT-Based Machine Learning Algorithm With ex vivo Validation

      There is a need to develop a validated algorithm for plaque characterization which can help to facilitate the standardization of optical coherence tomography (OCT) image interpretation of plaque morphology, and improve the efficiency and accuracy in the application of OCT imaging for the quantitative assessment of plaque vulnerability. In this study, a machine learning algorithm was implemented for characterization of atherosclerotic plaque components by intravascular OCT using ex vivo carotid plaque tissue samples. A total of 31 patients underwent carotid endarterectomy and the ex vivo carotid plaques were imaged with OCT. Optical parameter, texture features and relative position of pixels ...

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    21. Optical Coherence Tomography Facilitating Early Withdrawal of Antiplatelet Agents in a High–Bleeding Risk Patient

      Optical Coherence Tomography Facilitating Early Withdrawal of Antiplatelet Agents in a High–Bleeding Risk Patient

      Optical coherence tomography (OCT) can guide percutaneous coronary interventions to optimize results, thus minimizing the risk of stent thrombosis. We present the case of a cancer patient, paroxysmal atrial fibrillation, and unstable angina who underwent OCT–guided complex percutaneous coronary intervention and who required early discontinuation of antiplatelet therapy because of major bleeding. 

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    22. Looking in the mirror: An unusual optical coherence tomography image

      Looking in the mirror: An unusual optical coherence tomography image

      A 75-year-old male underwent primary angioplasty of a subocclusive proximal to medial left anterior descending artery (LAD) stenosis, involving the origin of the first diagonal (D1). A provisional stenting technique was used, with two guidewires in the distal LAD and D1 and implantation of 3 mm×30 mm and 2.75 mm×28 mm drug-eluting stents (DES) in the LAD. Withdrawal of the jailed D1 guidewire caused a deep intubation of the guide catheter into the LAD. The subsequent angiogram was notable for a suspicious haziness proximal to the stents ( Figure 1 A , arrow). We decided to perform optical coherence ...

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