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    1. The use of optical coherence tomography in diagnosis of HIV-associated atherosclerosis: Case report

      The use of optical coherence tomography in diagnosis of HIV-associated atherosclerosis: Case report

      Background and Aims: Patients with human immunodeficiency virus (HIV) are at higher risk for coronary artery disease, due to accelerated atherosclerosis resulting from chronic inflammation, the prevalence of cardiovascular risk factors and the side effects of highly active antiretroviral therapy (HAART). The atherosclerosis associated with HIV differs in important ways from atherosclerosis in the non-HIV setting. The present article aimed to report an unusual case of atherosclerosis in HIV-infected young women without any traditional cardiovascular risk factors on OCT.

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    2. “Plaque erosion” or the danger of eerily quiet appearance

      “Plaque erosion” or the danger of eerily quiet appearance

      The characteristic histopathological features of “plaque erosion” have been extensively unveiled ever since its first description more than 20 years ago [ 1 ]. Since then, the interest of both fundamental and clinical scientists working in atherosclerosis has kept rising, as reflected by the ever-growing number of articles published in this field. Yet, the effective impact of this entity, as well as its underlying mechanisms, has remained largely elusive due to the lack of specific imaging modalities and diagnostic tests, and the lack of appropriate experimental models. In this issue of Atherosclerosis , three excellent reviews give consistent fuel for thought by highlighting ...

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    3. Vascular imaging of atherosclerosis: Strengths and weaknesses

      Vascular imaging of atherosclerosis: Strengths and weaknesses

      Atherosclerosis is an inflammatory disease that can lead to several complications such as ischemic heart disease, stroke, and peripheral vascular disease. Therefore, researchers and clinicians rely heavily on the use of imaging modalities to identify, and more recently, quantify the burden of atherosclerosis in the aorta, carotid arteries, coronary arteries, and peripheral vasculature. These imaging techniques vary in invasiveness, cost, resolution, radiation exposure, and presence of artifacts. Consequently, a detailed understanding of the risks and benefits of each technique is crucial prior to their introduction into routine cardiovascular screening. Additionally, recent research in the field of microvascular imaging has proven ...

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    4. Coronary 18F-sodium fluoride PET detects high-risk plaque features on optical coherence tomography and CT-angiography in patients with acute coronary syndrome

      Coronary 18F-sodium fluoride PET detects high-risk plaque features on optical coherence tomography and CT-angiography in patients with acute coronary syndrome

      Background and aims 18 F-Sodium Fluoride Positron Emission Tomography ( 18 F-NaF PET) non-invasively detects micro-calcification activity, the earliest stage of atherosclerotic arterial calcification. We studied the association between coronary 18 F-NaF uptake and high-risk plaque features on intra-coronary optical coherence tomography (OCT) and CT-angiography (CTCA) and the potential application to patient-level risk stratification. Methods Sixty-two prospectively recruited patients with acute coronary syndrome (ACS) underwent multi-vessel OCT, 18 F-NaF PET and CTCA. The maximum tissue to background ratio (TBRmax= standardised uptake value (SUV)max/SUVbloodpool) was measured in each coronary segment on 18 F-NaF PET scans. High-risk plaque features on OCT ...

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    5. The relationship between residual cholesterol risk and plaque characteristics in patients with acute coronary syndrome: Insights from an optical coherence tomography study

      The relationship between residual cholesterol risk and plaque characteristics in patients with acute coronary syndrome: Insights from an optical coherence tomography study

      Background and aims The impact of residual cholesterol risk (RCR) on plaque characteristics is not fully understood. The study aims to explore the relationship between RCR and plaque features in patients presenting with acute coronary syndrome (ACS). Methods All ACS patients undergoing pre-intervention optical coherence tomography (OCT) with high-sensitivity C-reactive protein (hs-CRP) <2 mg/L on admission were retrospectively enrolled from January to December 2017, at Beijing Anzhen Hospital, Capita Medical University. RCR was defined as low density lipoprotein cholesterol (LDL-C) ≥1.8mmol/L. Patients were divided into the RCR and non-RCR groups according to baseline LDL-C. Results A total ...

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    6. Role of mechanical stress and neutrophils in the pathogenesis of plaque erosion

      Role of mechanical stress and neutrophils in the pathogenesis of plaque erosion

      Mechanical stress is a well-recognized driver of plaque rupture. Likewise, investigating the role of mechanical forces in plaque erosion has recently begun to provide some important insights, yet the knowledge is by far less advanced. The most significant example is that of shear stress, which has early been proposed as a possible driver for focal endothelial death and denudation. Recent findings using optical coherence tomography, computational sciences and mechanical models show that plaque erosion occurs most likely around atheromatous plaque throats with specific stress pattern. In parallel, we have recently shown that neutrophil-dependent inflammation promotes plaque erosion, possibly through a ...

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    7. Reviewing imaging modalities for the assessment of plaque erosion

      Reviewing imaging modalities for the assessment of plaque erosion

      Plaque rupture followed by intracoronary thrombus formation is recognized as the most common pathophysiological mechanism in acute coronary syndromes (ACS). The second most common underlying substrate for ACS is plaque erosion whose hallmark is thrombus formation without cap disruption. Invasive and non-invasive methods have emerged as a promising tool for evaluation of plaque features that either predict or detect plaque erosion. Optical coherence tomography (OCT), high-definition intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and near-infrared autofluorescence (NIRF) have been used to study plaque erosion. The detection of plaque erosion in the clinical setting, mainly facilitated by OCT, has shed light upon ...

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    8. New prediction tools and treatment for ACS patients with plaque erosion

      New prediction tools and treatment for ACS patients with plaque erosion

      For decades, we have known from autopsy observations that the proximate cause of the majority of acute coronary syndromes (ACS) is occlusive thrombosis generated by plaque rupture or, less frequently, superficial erosion.1-3 Mounting evidence supports the concept that these two substrates are separate entities, with distinct pathogenesis, clinical presentation, and prognosis.4-9 Yet, when ACS patients present to the emergency department with ischemic symptoms, we still triage them exclusively based on the presence or absence of ST-segment elevation on electrocardiogram and/or on troponin levels, assess them using coronary angiography, and manage them almost invariably with percutaneous coronary intervention ...

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    9. Macrophage infiltrates in coronary plaque erosion and cardiovascular outcome in patients with acute coronary syndrome

      Macrophage infiltrates in coronary plaque erosion and cardiovascular outcome in patients with acute coronary syndrome

      Background and aims Plaque erosion (PE) is responsible for at least one-third of acute coronary syndrome (ACS), and inflammation plays a key role in plaque instability. We assessed the presence of optical coherence tomography (OCT)-defined macrophage infiltrates (MØI) at the culprit site in ACS patients with PE, evaluating their clinical and OCT correlates, along with their prognostic value. Methods ACS patients undergoing OCT imaging and presenting PE as culprit lesion were retrospectively selected. Presence of MØI at culprit site was assessed. The incidence of major adverse cardiac events (MACEs), defined as the composite of cardiac death, recurrent ...

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    10. The relationship between coronary artery calcium density and optical coherence tomography-derived plaque characteristics

      The relationship between coronary artery calcium density and optical coherence tomography-derived plaque characteristics

      Background and aims Although coronary artery calcium (CAC) density has been associated with plaque stability, pathological evidence is lacking. We investigated the relationship between coronary computed tomography (CCT)-derived CAC density and multiple calcified and high-risk plaque (HRP) characteristics using optical coherence tomography (OCT). Methods We analyzed 83 plaques from 33 stable angina patients who underwent both CCT and OCT. CAC density was measured at calcium plaques with >90 Hounsfield units (HU) and >130 HU using custom CT software. The correlation between median CAC density and OCT-derived calcium size (thickness and area) was assessed. To investigate whether median CAC densities ...

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    11. A “light based biopsy” for high-risk atherosclerotic plaque

      A “light based biopsy” for high-risk atherosclerotic plaque

      Atherosclerosis is a dynamic systemic disease leading to progressive arterial plaque accumulation that is associated with a proportional increase in the risk of major adverse clinical events (MACE). Progression is non-linear and related to cycles of plaque destabilisation, erosion or rupture, which only occasionally result in MACE and mostly are followed by healing 1 . In clinical practice, healed plaque can be detected using optical coherence tomography (OCT). OCT utilises near infrared light for intra-coronary imaging and has a high resolution (10-20 μm), which is 10-20 times better than intravascular ultrasound (IVUS) and 20-40 times better than coronary CT-angiography. OCT is ...

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    12. 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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    13. Endothelial glycocalyx and severity and vulnerability of coronary plaque in patients with coronary artery disease

      Endothelial glycocalyx and severity and vulnerability of coronary plaque in patients with coronary artery disease

      Background and aims Endothelial glycocalyx covers the endothelium and maintains vascular integrity. However, its association with the severity and vulnerability of coronary artery disease (CAD) remains to be elucidated. Methods A total of 259 consecutive patients with stable CAD requiring percutaneous coronary intervention (PCI) were prospectively enrolled. Patients were classified into 2 groups according to the median value of serum syndecan-1, which is a core component of the endothelial glycocalyx (lower syndecan-1 group [syndecan-1 <99.0 ng/mL], n = 130; higher syndecan-1 group [syndecan-1 ≥99.0 ng/mL], n = 129). Severity of CAD and focal plaque vulnerability in culprit lesion ...

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    14. Relationship between elevated plasma ceramides and plaque rupture in patients with ST-segment elevation myocardial infarction

      Relationship between elevated plasma ceramides and plaque rupture in patients with ST-segment elevation myocardial infarction

      Background and aims Ceramides (Cer) is an atherogenic substance. However, the associations between specific plasma Cer levels and culprit plaque morphology in ST-segment elevation myocardial infarction (STEMI) patients are unclear. Methods The study consisted of two parallel cohorts. 100 consecutive patients with STEMI were screened as discovery cohort. In the validation cohort, we separately screened 30 normal donors, 30 stable angina pectoris (SAP) and 315 STEMI patients. All STEMI patients underwent emergency percutaneous intervention (PCI) and optical coherence tomography (OCT) examination for culprit plaque. Based on established diagnostic criteria, STEMI patients were classified into plaque rupture (PR) and plaque erosion ...

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      Mentions: Bo Yu
    15. Relationship of systemic pentraxin-3 values with coronary plaque components on optical coherence tomography and post-percutaneous coronary intervention outcomes in patients with stable angina pectoris

      Relationship of systemic pentraxin-3 values with coronary plaque components on optical coherence tomography and post-percutaneous coronary intervention outcomes in patients with stable angina pectoris

      Background and aims Elevated pentraxin-3 (PTX3) values are associated with vulnerable plaque existence and poor outcomes in acute coronary syndrome patients. The clinical significance of PTX3 values in stable angina pectoris (SAP) patients is, however, undetermined. We investigated the relationship of systemic PTX3 values and coronary plaque components and post-percutaneous coronary intervention (PCI) outcomes in SAP patients. Methods We included 93 consecutive de-novo lesions in 93 SAP patients with a normal pre-PCI high-sensitivity cardiac troponin-T (<0.014 ng/mL), undergoing pre- and post-PCI optical coherence tomography (OCT). Systemic PTX3 values were obtained immediately pre- and post-PCI, at 24-h and 9-month ...

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    16. Intravascular optical coherence tomography method for automated detection of macrophage infiltration within atherosclerotic coronary plaques

      Intravascular optical coherence tomography method for automated detection of macrophage infiltration within atherosclerotic coronary plaques

      Background and aims Significant macrophages infiltration in advanced atherosclerotic plaques promotes acute coronary events. Hence, the clinical imaging of macrophage content in coronary atherosclerotic plaques could potentially aid in identifying patients most at risk of future acute coronary events. The aim of this study was to introduce and validate a simple intravascular optical coherence tomography (IV-OCT) image processing method for automated, accurate and fast detection of macrophage infiltration within coronary atherosclerotic plaques. Methods This method calculates the ratio of the normalized-intensity standard deviation (NSD) values estimated over two axially-adjacent regions of interest in an IV-OCT cross-sectional image (B-scan). When applied ...

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      Mentions: Javier A. Jo
    17. Culprit lesion morphology in young patients with st-segment elevated myocardial infarction: A clinical, angiographic and optical coherence tomography study

      Culprit lesion morphology in young patients with st-segment elevated myocardial infarction: A clinical, angiographic and optical coherence tomography study

      Background and aims About 20% of patients with ST-segment elevated myocardial infarction (STEMI) are young adults. Morphological characteristics of culprit lesion in young STEMI patients have not been systematically evaluated in vivo . The present study aimed to investigate culprit lesion characteristics in young patients versus older patients using optical coherence tomography (OCT). Methods 1442 STEMI patients who underwent OCT examination of culprit lesion were included and divided into young group (age ≤50 years, n = 400) and older group (age >50 years, n = 1042). Clinical characteristics, angiography and OCT findings were compared between the two groups. Results Culprit lesions in STEMI ...

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    18. Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes

      Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes

      Background and aims The impact of late drug-eluting stent (DES) malapposition detected by optical coherence tomography (OCT) on long-term clinical outcomes has not been clearly established. We evaluated long-term clinical outcomes of late stent malapposition (LSM) detected by OCT in a qualified study population. Methods A total of 428 patients were selected from previous randomized OCT studies that evaluated the degree of strut coverage of different DESs at a 3–12-month follow-up OCT examination. These patients were assigned to one of two groups based on the presence (n = 136) or absence (n = 292) of LSM on follow-up OCT images (performed ...

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    19. Prediction of coronary thin-cap fibroatheroma by intravascular ultrasound-based machine learning

      Prediction of coronary thin-cap fibroatheroma by intravascular ultrasound-based machine learning

      ackground and aims Although grayscale intravascular ultrasound (IVUS) is commonly used for assessing coronary lesion morphology and optimizing stent implantation, detection of vulnerable plaques by IVUS remains challenging. We aimed to develop machine learning (ML) models for predicting optical coherence tomography-derived thin-cap fibroatheromas (OCT-TCFAs). Methods In 517 patients with angina, 414 and 103 coronary lesions were randomized into training vs. test sets. Each of the IVUS-OCT co-registered frames (including 32,807 for training and 8101 for test) was labeled according to the presence vs. absence of OCT-TCFA. Among 1449 computed IVUS features based on two-dimensional geometry and texture, 17 features ...

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    20. Incidence, factors, and clinical significance of cholesterol crystals in coronary plaque: An optical coherence tomography study

      Incidence, factors, and clinical significance of cholesterol crystals in coronary plaque: An optical coherence tomography study

      Background and aims Intraplaque cholesterol crystal (CC) is recognized as a component of vulnerable plaques. However, the clinical characteristics of patients with CC and the impact of CC on clinical events remain unknown. Methods A total of 340 consecutive patients who underwent optical coherence tomography (OCT) imaging of culprit lesions were included in the study. CC was defined as a thin linear structure with high reflectivity and low signal attenuation on OCT images. The incidence of major adverse cardiovascular events (MACE) at 1-year was compared between patients with CC (CC group) and those without CC (non-CC group). MACE included cardiac ...

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    21. In vivo optical coherence tomography imaging and histopathology of healed coronary plaques

      In vivo optical coherence tomography imaging and histopathology of healed coronary plaques

      Background and aims The aims of this study were to assess agreement between optical coherence tomography (OCT) and histopathology for healed coronary plaques (HCPs) in human coronary arteries ex vivo , and to evaluate the prevalence and characteristics of HCPs in vivo . Methods Ex vivo OCT images were co-registered with histopathology in 144 cross-sections with ≥50% stenosis. Of these, 30 randomly selected pairs were employed to define morphological features of OCT for HCPs (OCT-derived HCPs); the remaining 114 pairs were used to evaluate the accuracy of OCT in detecting histologically-defined HCPs. In a clinical study, 60 target lesions from 60 patients ...

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    22. Quantitative measurement of lipid rich plaque by coronary computed tomography angiography: A correlation of histology in sudden cardiac death

      Quantitative measurement of lipid rich plaque by coronary computed tomography angiography: A correlation of histology in sudden cardiac death

      Background and aims Recent advancements in coronary computed tomography angiography (CCTA) have allowed for the quantitative measurement of high-risk lipid rich plaque. Determination of the optimal threshold for Hounsfield units (HU) by CCTA for identifying lipid rich plaque remains unknown. We aimed to validate reliable cut-points of HU for quantitative assessment of lipid rich plaque. Methods 8 post-mortem sudden coronary death hearts were evaluated with CCTA and histologic analysis. Quantitative plaque analysis was performed in histopathology images and lipid rich plaque area was defined as intra-plaque necrotic core area. CCTA images were analyzed for quantitative plaque measurement. Low attenuation plaque ...

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      Mentions: Renu Virmani
    1-24 of 46 1 2 »
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