1. Articles in category: Cardiology

    1-24 of 4786 1 2 3 4 ... 198 199 200 »
    1. Culprit-Plaque Morphology and Residual SYNTAX Score Predict Cardiovascular Risk in Acute Myocardial Infarction: An Optical Coherence Tomography Study

      Culprit-Plaque Morphology and Residual SYNTAX Score Predict Cardiovascular Risk in Acute Myocardial Infarction: An Optical Coherence Tomography Study

      Aims: Culprit-plaque morphology [plaque rupture (PR) and plaque erosion (PE)] and high-risk plaques (HRP) identified by optical coherence tomography (OCT) and residual SYNTAX score (rSS) have been reported to influence clinical outcomes. Thus, in this study, we aimed to investigate the prognostic implication of culprit-plaque morphology and rSS for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: Based on plaque morphology and rSS, 274 STEMI patients were divided into 4 groups: PE/low-rSS (n=61), PE/high-rSS (n=58), PR/low-rSS (n=55), and PR/high-rSS (n=100). According to HRP and rSS, patients ...

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    2. Optical Coherence Tomography of Plaque Vulnerability and Rupture: JACC Focus Seminar Part 1/3

      Optical Coherence Tomography of Plaque Vulnerability and Rupture: JACC Focus Seminar Part 1/3

      Plaque rupture is the most common cause of acute coronary syndromes and sudden cardiac death. Characteristics and pathobiology of vulnerable plaques prone to plaque rupture have been studied extensively over 2 decades in humans using optical coherence tomography (OCT), an intravascular imaging technique with micron scale resolution. OCT studies have identified key features of plaque vulnerability and described the in vivo characteristics and spatial distribution of thin cap fibroatheromas as major precursors to plaque rupture. In addition, OCT data supports the evolving understanding of coronary heart disease as a panvascular process associated with inflammation. In the setting of high atherosclerotic ...

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    3. Optical Coherence Tomography of Plaque Erosion: JACC Focus Seminar Part 2/3

      Optical Coherence Tomography of Plaque Erosion: JACC Focus Seminar Part 2/3

      Plaque erosion, a distinct histopathological and clinical entity, accounts for over 30% of acute coronary syndromes (ACS). Optical coherence tomography allows in vivo diagnosis of plaque erosion. Local flow perturbation with activation of Toll-like receptor 2 and CD8 + T cells and subsequent desquamation of endothelium and neutrophil extracellular trap formation contribute to mechanisms of plaque erosion. Compared with ACS patients with plaque rupture, those with plaque erosion are younger, have fewer traditional cardiovascular risk factors, have lower plaque burden, and are more likely to present with non-ST-segment elevation ACS. Early evidence suggests that in patients with ACS caused by plaque ...

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    4. Optical Coherence Tomography of Coronary Plaque Progression and Destabilization: JACC Focus Seminar Part 3/3

      Optical Coherence Tomography of Coronary Plaque Progression and Destabilization: JACC Focus Seminar Part 3/3

      The development of optical coherence tomography (OCT) has revolutionized our understanding of coronary artery disease. In vivo OCT research has paralleled with advances in computational fluid dynamics, providing additional insights in the various hemodynamic factors influencing plaque growth and stability. Recent OCT studies introduced a new concept of plaque healing in relation to clinical presentation. In addition to known mechanisms of acute coronary syndromes such as plaque rupture and plaque erosion, a new classification of calcified plaque was recently reported. This review will focus on important new insights that OCT has provided in recent years into coronary plaque development, progression ...

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    5. Arterial wall characterization in optical coherence tomography imaging

      Arterial wall characterization in optical coherence tomography imaging

      A method, including: obtaining, by a processor, imaging data from a vessel; detecting, using the processor, an inner wall of the vessel based on the imaging data; identifying, using the processor, a plurality of visible edge portions of an outer wall of the vessel based on the imaging data; fitting, using the processor, a continuous surface model to the plurality of identified visible edge portions of the outer wall; and detecting, using the processor, the outer wall of the vessel based on fitting the continuous surface model to the plurality of identified visible edge portions of the outer wall such ...

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    6. Improved U-Net for Plaque Segmentation of Intracoronary Optical Coherence Tomography Images

      Improved U-Net for Plaque Segmentation of Intracoronary Optical Coherence Tomography Images

      Optical coherence tomography (OCT) has been widely used in the assessment of coronary atherosclerotic plaques. Traditional machine learning methods are mainly based on the image texture features for the plaque segmentation. However, the texture features only represent the information of the local area, which may lead to unsatisfactory results. U-Net and its improved versions use continuous convolution and pooling to extract more advanced features, resulting in the loss of image spatial information and low plaque segmentation accuracy. This paper introduces a spatial pyramid pooling module and a multi-scale dilated convolution module into the U-Net to capture more advanced features while ...

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    7. Association between apolipoprotein B/A1 ratio and coronary plaque vulnerability in patients with atherosclerotic cardiovascular disease: an intravascular optical coherence tomography study

      Association between apolipoprotein B/A1 ratio and coronary plaque vulnerability in patients with atherosclerotic cardiovascular disease: an intravascular optical coherence tomography study

      Background: Apolipoprotein (Apo) A1 and Apo B are strongly associated with the risk of atherosclerotic cardiovascular disease (ASCVD). However, the relationship between the Apo B/A1 ratio and the morphology of coronary vulnerable plaques has not been fully elucidated in patients with ASCVD. Methods: A total of 320 patients with ASCVD undergoing percutaneous coronary intervention were enrolled and assigned into acute coronary syndrome (ACS) or chronic coronary syndrome (CCS) group. The morphology of culprit plaque was analyzed by intravascular optical coherence tomography. Association between the Apo B/A1 ratio and coronary vulnerable plaques were evaluated using logistic regression models and ...

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    8. Macrophage targeted theranostic strategy for accurate detection and rapid stabilization of the inflamed high-risk plaque

      Macrophage targeted theranostic strategy for accurate detection and rapid stabilization of the inflamed high-risk plaque

      Rationale: Inflammation plays a pivotal role in the pathogenesis of the acute coronary syndrome. Detecting plaques with high inflammatory activity and specifically treating those lesions can be crucial to prevent life-threatening cardiovascular events. Methods: Here, we developed a macrophage mannose receptor (MMR)-targeted theranostic nanodrug (mannose-polyethylene glycol-glycol chitosan-deoxycholic acid-cyanine 7-lobeglitazone; MMR-Lobe-Cy) designed to identify inflammatory activity as well as to deliver peroxisome proliferator-activated gamma (PPARγ) agonist, lobeglitazone, specifically to high-risk plaques based on the high mannose receptor specificity. The MMR-Lobe-Cy was intravenously injected into balloon-injured atheromatous rabbits and serial in vivo optical coherence tomography (OCT)-near-infrared fluorescence (NIRF) structural-molecular imaging ...

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      Mentions: Korea University
    9. The invasive intracoronary imaging assessment of left main coronary artery disease

      The invasive intracoronary imaging assessment of left main coronary artery disease

      Left main coronary artery disease is associated with an unfavorable prognosis. Evidence-based decision making regarding the optimal revascularization strategy in patients with left main disease has become a challenge, in view of the recently published data. An improvement in outcomes following left main percutaneous interventions could be achieved by reducing the rate of repeat target lesion revascularization through stent optimization techniques. In the setting of left main disease, procedural guidance by intravascular ultrasound or optical coherence tomography is essential for good long-term results, in such a way that intravascular imaging has gained more of a therapeutic connotation. Besides stent optimization ...

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    10. Head-to-head comparison of quantitative measurements between intravascular imaging systems: An in vitro phantom study

      Head-to-head comparison of quantitative measurements between intravascular imaging systems: An in vitro phantom study

      Introduction The present study aimed to compare the accuracy of quantitative measurements by contemporary intravascular imaging systems including optical frequency domain imaging (OFDI), frequency domain optical coherence tomography (FD-OCT), and 6 intravascular ultrasound (IVUS) systems. Methods We imaged five cylindrical phantom models made from an acrylic resin with known lumen diameters (1.51, 2.03, 3.04, 4.04, and 5.04 mm, respectively) using OFDI (FastView and LUNAWAVE, Terumo), FD-OCT (Dragonfly JP and ILUMIEN OPTIS, Abbott Vascular), and 6 mechanically rotating IVUS systems including a system, two 40-MHz, one 45-MHz, two 60-Mhz and one broad-band frequency IVUS systems. The ...

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    11. Using Optical Coherence Tomography and Intravascular Ultrasound Imaging to Quantify Coronary Plaque Cap Stress/Strain and Progression: A Follow-Up Study Using 3D Thin-Layer Models

      Using Optical Coherence Tomography and Intravascular Ultrasound Imaging to Quantify Coronary Plaque Cap Stress/Strain and Progression: A Follow-Up Study Using 3D Thin-Layer Models

      Accurate plaque cap thickness quantification and cap stress/strain calculations are of fundamental importance for vulnerable plaque research. To overcome uncertainties due to intravascular ultrasound (IVUS) resolution limitation, IVUS and optical coherence tomography (OCT) coronary plaque image data were combined together to obtain accurate and reliable cap thickness data, stress/strain calculations, and reliable plaque progression predictions. IVUS, OCT, and angiography baseline and follow-up data were collected from nine patients (mean age: 69; m: 5) at Cardiovascular Research Foundation with informed consent obtained. IVUS and OCT slices were coregistered and merged to form IVUS + OCT (IO) slices. A total of ...

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    12. Lesion Preparation with Orbital Atherectomy

      Lesion Preparation with Orbital Atherectomy

      Despite significant improvements in stent design, severe coronary calcification continues to impede adequate stent expansion and is associated with worse clinical outcomes. Angiography is limited in its ability to detect and comprehensively characterise calcified plaque. Intravascular imaging provides information on lesion morphology guiding appropriate treatment strategies. Orbital atherectomy allows for lesion preparation of severely calcified plaque prior to stent implantation. Utilising a unique mechanism of action incorporating centrifugal forces, a standard 1.25 mm eccentrically mounted and diamond-coated burr orbits bi-directionally to ablate calcified plaque. Lesion preparation with orbital atherectomy allows for modification of calcified plaque to facilitate stent expansion.

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    13. Plasma Pentraxin-3 Combined with Plaque Characteristics Predict Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study

      Plasma Pentraxin-3 Combined with Plaque Characteristics Predict Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study

      Background: Culprit‑plaque morphology [plaque rupture (PR) and plaque erosion (PE) identified by optical coherence tomography (OCT)] and biomarker of vascular inflammation, pentraxin-3 (PTX3), have been reported to influence clinical outcomes in coronary diseases. We aimed to investigate the prognostic implication of culprit-plaque morphology and plasma PTX3 for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 236 patients were enrolled and divided into four groups: PE/low-PTX3 (n = 57), PE/high-PTX3 (n = 47), PR/low-PTX3 (n = 78) and PR/high-PTX3 (n = 54). MACE was defined as the composite of all-cause death ...

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    14. Coronary plaque and clinical characteristics of South Asian (Indian) patients with acute coronary syndromes: An optical coherence tomography study

      Coronary plaque and clinical characteristics of South Asian (Indian) patients with acute coronary syndromes: An optical coherence tomography study

      Background South Asians, and Indians in particular, are known to have a higher incidence of premature atherosclerosis and acute coronary syndromes (ACS) with worse clinical outcomes, compared to populations with different ethnic backgrounds. However, the underlying pathobiology accounting for these differences has not been fully elucidated. Methods ACS patients who had culprit lesion optical coherence tomography (OCT) imaging were enrolled. Culprit plaque characteristics were evaluated using OCT. Results Among 1315 patients, 100 were South Asian, 1009 were East Asian, and 206 were White. South Asian patients were younger (South Asians vs. East Asians vs. Whites: 51.6 ± 13.4 vs ...

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    15. Successful optical coherence tomography-guided treatment in a 19-year-old patient with ST-segment elevation myocardial infarction caused by plaque erosion

      Successful optical coherence tomography-guided treatment in a 19-year-old patient with ST-segment elevation myocardial infarction caused by plaque erosion

      ST-segment elevation myocardial infarction is a type of coronary atherosclerotic heart disease, and its pathophysiological mechanism is formation of lipid plaques. We report a 19-year-old patient with ST-segment elevation myocardial infarction caused by plaque erosion, but he did not have any common traditional risk factors of lipid plaques. His treatment was guided by optical coherence tomography. He received successful treatment and had a good prognosis. Optical coherence tomography can be used to help understand the pathogenesis of myocardial infarction and visualize the real lumen.

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    16. Interventional Strategy for Non-culprit Lesions With Major Vulnerability Criteria at OCT in Patients With ACS

      Interventional Strategy for Non-culprit Lesions With Major Vulnerability Criteria at OCT in Patients With ACS

      he INTERCLIMA (Interventional Strategy for Non-culprit Lesions With Major Vulnerability Criteria Identified by Optical Coherence Tomography in Patients With Acute Coronary Syndrome) is a multi-center, prospective, randomized trial of optical coherence tomography (OCT)-based versus physiology-based (i.e. fractional flow reserve[FFR]/instantaneous Wave-Free Ratio[iFR]/resting full-cycle ratio[RFR]) treatment of intermediate (40-70% diameter stenosis at quantitative coronary angiography), non-culprit coronary lesions in acute coronary syndrome (ACS) patients undergoing coronary angiography. About 1400 patients with ACS will be randomized into the study at approximately 40 sites worldwide.

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    17. Atherogenesis in Native Coronary Segments and In-Stent Neoatherogenesis Beyond Three Years After First-Generation Drug-Eluting Stent Implantation: Angiographic and Optical Coherence Tomography Study

      Atherogenesis in Native Coronary Segments and In-Stent Neoatherogenesis Beyond Three Years After First-Generation Drug-Eluting Stent Implantation: Angiographic and Optical Coherence Tomography Study

      Objectives: The mechanisms underlying the development of neoatherosclerosis following stent implantation remain to be further elucidated. The aim of this study was to investigate the association between subclinical in-stent neoatherosclerosis (NA) and atherosclerosis progression of native coronary segments in patients with chronic coronary syndrome 3 and 9 years after first-generation drug-eluting stent implantation. Methods: This is a prespecified analysis of the prospective cohort study evaluating long-term neointimal healing in consecutive patients undergoing elective percutaneous coronary intervention with sirolimus-eluting stent (SES) or paclitaxel-eluting stent (PES) implantation. Quantitative coronary angiography (QCA) was evaluated in non-stented coronary segments. Results: Forty-three patients underwent optical ...

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    18. Assessing the Impact of Colchicine on Coronary Plaque Phenotype After Myocardial Infarction with Optical Coherence Tomography: Rationale and Design of the COCOMO-ACS Study

      Assessing the Impact of Colchicine on Coronary Plaque Phenotype After Myocardial Infarction with Optical Coherence Tomography: Rationale and Design of the COCOMO-ACS Study

      Introduction: Recurrent event rates after myocardial infarction (MI) remain unacceptably high, in part because of the continued growth and destabilization of residual coronary atherosclerotic plaques, which may occur despite lipid-lowering therapy. Inflammation is an important contributor to this ongoing risk. Recent studies have shown that the broad-acting anti-inflammatory agent, colchicine, may reduce adverse cardiovascular events in patients post-MI, although the mechanistic basis for this remains unclear. Advances in endovascular arterial wall imaging have allowed detailed characterization of the burden and compositional phenotype of coronary plaque, along with its natural history and responsiveness to treatment. One such example has been the ...

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    19. Self-assembling human heart organoids for the modeling of cardiac development and congenital heart disease | Nature Communications

      Self-assembling human heart organoids for the modeling of cardiac development and congenital heart disease | Nature Communications

      Congenital heart defects constitute the most common human birth defect, however understanding of how these disorders originate is limited by our ability to model the human heart accurately in vitro. Here we report a method to generate developmentally relevant human heart organoids by self-assembly using human pluripotent stem cells. Our procedure is fully defined, efficient, reproducible, and compatible with high-content approaches. Organoids are generated through a three-step Wnt signaling modulation strategy using chemical inhibitors and growth factors. Heart organoids are comparable to age-matched human fetal cardiac tissues at the transcriptomic, structural, and cellular level. They develop sophisticated internal chambers with ...

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    20. Optical coherence tomography tissue coverage and characterization at six months after implantation of bioresorbable scaffolds versus conventional everolimus eluting stents in the ISAR-Absorb MI trial

      Optical coherence tomography tissue coverage and characterization at six months after implantation of bioresorbable scaffolds versus conventional everolimus eluting stents in the ISAR-Absorb MI trial

      Purpose: Data regarding vessel healing by optical coherence tomography (OCT) after everolimus-eluting bioresorbable scaffolds (BRS) or everolimus-eluting metallic stent (EES) implantation in acute myocardial infarction (AMI) patients is scarce. We compared OCT findings after BRS or EES implantation in patients with AMI enrolled in a randomized trial. Methods: In ISAR-Absorb MI, AMI patients were randomized to BRS or EES implantation, with 6-8 month angiographic follow-up. This analysis includes patients who underwent OCT during surveillance angiography. Tissue characterization was done using grey-scale signal intensity analysis. The association between OCT findings and target lesion failure (TLF) at 2 years was investigated. Results ...

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    21. Optical Coherence Tomography in Cardiac Allograft Vasculopathy: State-of-the-Art Review

      Optical Coherence Tomography in Cardiac Allograft Vasculopathy: State-of-the-Art Review

      Cardiac allograft vasculopathy (CAV) is a challenging complication of heart transplantation. CAV pathophysiology is incompletely understood, standard screening modalities such as angiography have significant limitations, and currently available therapies have only modest efficacy in preventing progression. Optical coherence tomography is a light-based technique that provides microscopic level catheter-based intravascular imaging and has dramatically expanded our understanding of CAV, demonstrating it to be a complex, heterogeneous, and dynamic process. This review covers characteristics and uses of optical coherence tomography, including vessel characterization, serial use to assess progression of disease, guiding percutaneous intervention, and monitoring response to CAV therapies. We also discuss ...

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