Correlation of Longitudinal Intravascular Ultrasound Data for the Clinical Assessment of Coronary Artery Disease Progression

2012 ◽  
Author(s):  
Lucas H. Timmins ◽  
Jonathan D. Suever ◽  
Parham Eshtehardi ◽  
Michael C. McDaniel ◽  
Habib Samady ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Disease Progression ◽  
Intravascular Ultrasound ◽  
Atherosclerotic Lesion ◽  
Plaque Progression ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Artery Disease ◽  
The Impact

Virtual histology-intravascular ultrasound (VH-IVUS) has gained increasing utility in the cardiac catheterization laboratory, not only in determining underlying atherosclerotic lesion composition prior to stent placement, but also in clinical studies assessing the natural history of coronary artery disease (CAD) [1]. Furthermore, VH-IVUS has provided an excellent means of quantifying disease progression by comparing data sets collected over time (i.e., longitudinal studies) and potentially identifying rapidly progressing and potentially vulnerable plaques. One difficulty, however, in analyzing VH-IVUS derived CAD progression is the accurate co-registration of image sets collected over a period of time. Commonly, an expert VH-IVUS image reader reviews these image sets side-by-side on a display and co-registers images along the vessel main axis, herein axially co-registered, by identifying image locations relative to fiduciary anatomical markers (e.g., branches). Despite this method being the standard for analyzing CAD progression, it is limited by the inability to accurately co-register VH-IVUS data in the circumferential direction (i.e., rotating images such that their cylindrical coordinate bases coincide; herein circumferentially co-registered). Thus, a significant amount of information on focal plaque progression is lost that could provide a greater understanding of the natural evolution of CAD, the effects of various pharmaceutical agents (e.g., statins) on lesion composition changes, and the impact of local mechanical factors that induce plaque progression/regression and transformation.

scholarly journals Implications of age in coronary artery disease progression. A serial, volumetric, intravascular ultrasound study

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P2416-P2416 ◽  
Author(s):  
L. Hernando Marrupe ◽  
A. Suarez Cuervo ◽  
R. Hernandez Antolin ◽  
C. Banuelos ◽  
N. Gonzalo ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Disease Progression ◽  
Intravascular Ultrasound ◽  
Ultrasound Study ◽  
Artery Disease ◽  
Coronary Artery Disease Progression

scholarly journals Coronary Physiology in the Cardiac Catheterization Laboratory

2019 ◽  
Vol 8 (2) ◽  
pp. 255 ◽  
Author(s):  
Samit Shah ◽  
Steven Pfau
Keyword(s):  
Coronary Artery Disease ◽  
Clinical Trials ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Flow ◽  
Coronary Physiology ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Flow Reserve ◽  
Artery Disease

Coronary angiography has been the principle modality for assessing the severity of atherosclerotic coronary artery disease for several decades. However, there is a complex relationship between angiographic coronary stenosis and the presence or absence of myocardial ischemia. Recent technological advances now allow for the assessment of coronary physiology in the catheterization laboratory at the time of diagnostic coronary angiography. Early studies focused on coronary flow reserve (CFR) but more recent work has demonstrated the physiologic accuracy and prognostic value of the fractional flow reserve (FFR) and instantaneous wave free ratio (iFR) for the assessment of coronary artery disease. These measurements have been validated in large multi-center clinical trials and have become indispensable tools for guiding revascularization in the cardiac catheterization laboratory. The physiological assessment of chest pain in the absence of epicardial coronary artery disease involves coronary thermodilution to obtain the index of microcirculatory resistance (IMR) or Doppler velocity measurement to determine the coronary flow velocity reserve (CFVR). Physiology-based coronary artery assessment brings “personalized medicine” to the catheterization laboratory and allows cardiologists and referring providers to make decisions based on objective findings and evidence-based treatment algorithms. The purpose of this review is to describe the theory, technical aspects, and relevant clinical trials related to coronary physiology assessment for an intended audience of general medical practitioners.

The Impact of Coronary Artery Disease Risk Factors on Intravascular Ultrasound-Derived Morphologic Indices of Human Coronaries

2006 ◽  
Vol 23 (4) ◽  
pp. 308-311 ◽  
Author(s):  
Jaskamal P.S. Kahlon ◽  
James Torey ◽  
Cheryl K. Nordstrom ◽  
Thomas A. LaLonde ◽  
Arshad Ali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Disease Risk ◽  
Coronary Artery Disease Risk ◽  
Artery Disease ◽  
The Impact

scholarly journals Physiological Assessment of Coronary Artery Disease in the Cardiac Catheterization Laboratory

Circulation ◽  
2006 ◽  
Vol 114 (12) ◽  
pp. 1321-1341 ◽  
Author(s):  
Morton J. Kern ◽  
Amir Lerman ◽  
Jan-Willen Bech ◽  
Bernard De Bruyne ◽  
Eric Eeckhout ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Catheterization ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Physiological Assessment ◽  
Artery Disease

The Impact of Smoking on Cardiovascular Outcomes and Comorbidities in Statin-treated Patients with Coronary Artery Disease: A Post hoc Analysis of the GREACE Study

2013 ◽  
Vol 11 (5) ◽  
pp. 779-784 ◽  
Author(s):  
Vasilios G. Athyros ◽  
Konstantinos Tziomalos ◽  
Niki Katsiki ◽  
Thomas D. Gossios ◽  
Olga Giouleme ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Outcomes ◽  
Post Hoc Analysis ◽  
Artery Disease ◽  
Post Hoc ◽  
The Impact

scholarly journals Impact of Coronary CT angiography in combination with CAD-RADS on the management of coronary artery disease patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
F Andre ◽  
S Seitz ◽  
P Fortner ◽  
R Sokiranski ◽  
F Gueckel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Coronary Ct Angiography ◽  
Patient Management ◽  
Male Gender ◽  
Coronary Ct ◽  
History Of ◽  
Artery Disease ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Siemens Healthineers Introduction Coronary CT angiography (CCTA) plays an increasing role in the detection and risk stratification of patients with coronary artery disease (CAD). The Coronary Artery Disease – Reporting and Data System (CAD-RADS) allows for standardized classification of CCTA results and, thus, may improve patient management. Purpose Aim of this study was to assess the impact of CCTA in combination with CAD-RADS on patient management and to identify the impact of cardiovascular risk factors (CVRF) on CAD severity. Methods CCTA was performed on a third-generation dual-source CT scanner in patients, who were referred to a radiology centre by their attending physicians. In a total of 4801 patients, CVRF were derived from medical reports and anamnesis. Results The study population consisted of 4770 patients (62.0 (54.0-69.0) years, 2841 males) with CAD (CAD-RADS 1-5), while 31 patients showed no CAD and were excluded from further analyses. Age, male gender and the number of CVRF were associated with more severe CAD stages (all p < 0.001). 3040 patients (63.7 %) showed minimal or mild CAD requiring optimization of CVRF i.e. medical therapy but no further assessment at his time. A group of 266 patients (5.6 %) had a severe CAD defined as CAD-RADS 4B/5. In the multivariate regression analysis, age, male gender, history of smoking, diabetes mellitus and hyperlipidaemia were significant predictors for severe CAD, whereas arterial hypertension and family history of CAD did not reach significance. Of note, a subgroup of 28 patients (10.5 %) with a severe CAD (68.5 (65.5-70.0) years, 26 males, both p = n.s.) had no CVRF. Conclusions CCTA in combination with the CAD-RADS allowed for effective risk stratification of CAD patients. The majority of the patients showed non-obstructive CAD and, thus, could be treated conservatively without the need for further CAD assessment. CVRF out of arterial hypertension and family history had an impact on CAD severity reflected in higher CAD-RADs gradings. Of note, a relevant fraction of patients with CAD did not have any CVRF and, thus, may not be covered by risk stratification models. CAD-RADS n Age (years) Males (%) 1 1453 56.0 (50.0-62.0) 623 (42.9 %) 2 1587 62.0 (55.0-69.0) 918 (57.8 %) 3 1067 66.0 (59.0-71.0) 749 (70.2 %) 4A 397 66.0 (59.0-72.0) 317 (79.8 %) 4B 162 67.0 (61.0-74.0) 139 (85.8 %) 5 104 66.0 (58.5.0-77.0) 95 (91.3 %)

scholarly journals Impact of established cardiovascular disease on 10-year death after coronary revascularization for complex coronary artery disease

2021 ◽  
Author(s):  
Rutao Wang ◽  
Scot Garg ◽  
Chao Gao ◽  
Hideyuki Kawashima ◽  
Masafumi Ono ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Revascularization ◽  
Long Term Outcomes ◽  
Vital Status ◽  
Increased Risk ◽  
Artery Disease ◽  
The Impact

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract

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