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Gan L, Feng C, Liu C, Tian S, Song X, Yang L. Association between serum N-terminal pro-B-type natriuretic peptide levels and characteristics of coronary atherosclerotic plaque detected by coronary computed tomography angiography. Exp Ther Med 2016; 12:667-675. [PMID: 27446259 PMCID: PMC4950222 DOI: 10.3892/etm.2016.3371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 01/15/2016] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to explore the association between the levels of serum N-terminal pro-B-type natriuretic peptide (NT-pro BNP) and the characteristics of coronary atherosclerotic plaque detected by coronary computed tomography angiography (CCTA), in patients with unstable angina (UA). A total of 202 patients (age range, 47-82 years) were divided into the following three groups: Non-cardiac disease group (57 patients); stable angina pectoris (SAP) group (62 patients); and UA group (83 patients). There were significant differences between the serum NT-pro BNP levels among the three groups (P=0.007). However, in multivariant diagnoses, NT-pro BNP level was not an independent risk factor for UA. The levels of serum NT-pro BNP were observed to be positively correlated with the number of vessels involved (r=0.462; P<0.001), SIS (r=0.475; P<0.001), segment-stenosis score (r=0.453; P<0.001), coronary calcification score (r=0.412; P=0.001), number of obstructive diseases (r=0.346; P<0.001), and the number of segments with non-calcified plaque (r=0.235; P=0.017), mixed plaque (r=0.234; P=0.017) and calcified plaque (r=0.431; P<0.001). The levels of serum NT-pro BNP were significantly higher in patients with UA and left main-left anterior descending (LM-LAD) disease, compared with UA patients without LM-LAD disease (P<0.001). In addition, serum NT-pro BNP was significantly higher in patients with obstructive disease and UA than in those without obstructive disease (P<0.001). The area under the curve of log(NT-pro BNP) was 0.656 (P=0.006; optimal cut-off value, 1.74; sensitivity, 77.6%; specificity, 51.9%). In conclusion, the levels of serum NT-pro BNP are associated with the burden and severity of coronary artery atherosclerotic disease in patients with UA, and may be helpful in risk stratification of patients with UA.
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Affiliation(s)
- Lu Gan
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Cong Feng
- Department of Emergency, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Chunlei Liu
- The PLA Medical College, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Shuping Tian
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Xiang Song
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Li Yang
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
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Hosaka A, Kato M, Motoki M, Sugai H, Okubo N. Quantified Aortic Luminal Irregularity as a Predictor of Complications and Prognosis After Endovascular Aneurysm Repair. Medicine (Baltimore) 2016; 95:e2863. [PMID: 26945368 PMCID: PMC4782852 DOI: 10.1097/md.0000000000002863] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Atheromatous degeneration of the aorta is considered to be a risk factor for postoperative embolic complications after endovascular treatment, and is associated with a high incidence of vascular events in the long term. We devised a method to quantify the shagginess of the aorta using contrast-enhanced computed tomography (CT) images. This study examined the method's validity and prognostic usefulness in patients undergoing elective endovascular abdominal aortic aneurysm repair (EVAR). We retrospectively investigated 427 patients who underwent elective EVAR between 2007 and 2013. Preoperative contrast-enhanced CT images with a slice thickness of 1 mm were analyzed using a workstation, and the degree of aortic luminal irregularity from the level of the left subclavian artery ostium to that of the celiac artery ostium was quantified by computing a shagginess score. We compared the computed scores with subjective visual assessments of aortic shagginess. Subsequently, we evaluated the relationship between the computed scores and postoperative prognosis. The shagginess scores were significantly correlated with the visual assessments of the aortic lumen, which were performed by 5 experienced vascular surgeons (rho ranged from 0.564-0.654, all P < 0.001). Multiple logistic regression analysis demonstrated that the shagginess score was independently associated with the development of renal impairment within a month after EVAR (odds ratio, 2.78; 95% confidence interval [CI], 1.83-4.22, P < 0.001). The shagginess score was significantly higher in patients who suffered postoperative intestinal and peripheral ischemic complications, as compared with those who did not (P < 0.001). The mean postoperative follow-up period was 1207 ± 641 days. Cox proportional hazards regression showed that the shagginess score was a significant independent predictor of all-cause and cardiovascular mortality (hazard ratio [HR], 1.37; 95% CI, 1.09-1.72, P = 0.007, and HR, 1.51; 95% CI, 1.04-2.18, P = 0.030, respectively). The results suggest that the shagginess score provides a quantitative reflection of aortic luminal irregularity. It may serve as a useful predictive factor for postoperative renal function deterioration, embolic complications, and long-term mortality after elective EVAR.
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Affiliation(s)
- Akihiro Hosaka
- From the Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo (AH), and Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka (MK, MM, HS, NO), Japan
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Di Marco L, Rosset M, Zhang-Yin J, Ohana M. [Multimodal imaging of ischemic heart diseases: A 2015 update]. Rev Med Interne 2016; 37:350-62. [PMID: 26775644 DOI: 10.1016/j.revmed.2015.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/08/2015] [Accepted: 12/08/2015] [Indexed: 11/26/2022]
Abstract
Current realities and future possibilities of imaging in the ischemic heart diseases are very broad and constantly evolving, with the improvement of existing technologies and the introduction of new features such as dual-energy CT, strain ultrasound, multimodality fusion or perfusion MRI. Regular collaboration between prescribing clinicians, cardiologists, radiologists and nuclear radiologists is therefore essential to tailor the examination to the specific clinical question. The indications for each modality will therefore depend on its diagnostic performance, cost, acquisition and post-processing times and eventual radiation exposure. This review will detail principles and applications of current cardiac imaging examinations: echocardiography, nuclear medicine, MRI, CT and coronary angiography, emphasizing their current strengths and weaknesses in the ischemic heart diseases management.
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Affiliation(s)
- L Di Marco
- Imagerie, Bocage Central, 14, rue Paul-Gaffarel, 21000 Dijon, France.
| | - M Rosset
- Cardiologie, hôpital Louis-Pradel, 28, avenue du Doyen-Jean-Lépine, 69500 Bron, France
| | - J Zhang-Yin
- Médecine nucléaire, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
| | - M Ohana
- Imagerie, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
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Athanasiou L, Rigas G, Sakellarios AI, Exarchos TP, Siogkas PK, Bourantas CV, Garcia-Garcia HM, Lemos PA, Falcao BA, Michalis LK, Parodi O, Vozzi F, Fotiadis DI. Three-dimensional reconstruction of coronary arteries and plaque morphology using CT angiography--comparison and registration with IVUS. BMC Med Imaging 2016; 16:9. [PMID: 26785613 PMCID: PMC4719213 DOI: 10.1186/s12880-016-0111-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 01/13/2016] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study is to present a new methodology for three-dimensional (3D) reconstruction of coronary arteries and plaque morphology using Computed Tomography Angiography (CTA). Methods The methodology is summarized in six stages: 1) pre-processing of the initial raw images, 2) rough estimation of the lumen and outer vessel wall borders and approximation of the vessel’s centerline, 3) manual adaptation of plaque parameters, 4) accurate extraction of the luminal centerline, 5) detection of the lumen - outer vessel wall borders and calcium plaque region, and 6) finally 3D surface construction. Results The methodology was compared to the estimations of a recently presented Intravascular Ultrasound (IVUS) plaque characterization method. The correlation coefficients for calcium volume, surface area, length and angle vessel were 0.79, 0.86, 0.95 and 0.88, respectively. Additionally, when comparing the inner and outer vessel wall volumes of the reconstructed arteries produced by IVUS and CTA the observed correlation was 0.87 and 0.83, respectively. Conclusions The results indicated that the proposed methodology is fast and accurate and thus it is likely in the future to have applications in research and clinical arena.
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Affiliation(s)
- Lambros Athanasiou
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO Box 1186, GR 45110, Ioannina, Greece
| | - George Rigas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO Box 1186, GR 45110, Ioannina, Greece
| | - Antonis I Sakellarios
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO Box 1186, GR 45110, Ioannina, Greece
| | - Themis P Exarchos
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO Box 1186, GR 45110, Ioannina, Greece.,FORTH-Institute of Molecular Biology and Biotechnology, Department of Biomedical Research, GR 45110, Ioannina, Greece
| | - Panagiotis K Siogkas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO Box 1186, GR 45110, Ioannina, Greece
| | - Christos V Bourantas
- Department of Cardiology, Barts Heart Centre, London, UK.,Department of Cardiovascular Science, University College London, London, UK
| | - Hector M Garcia-Garcia
- Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands
| | - Pedro A Lemos
- Department of Interventional Cardiology, Heart Institute, University of São Paulo, Medical School, São Paulo, Brazil
| | - Breno A Falcao
- Department of Interventional Cardiology, Heart Institute, University of São Paulo, Medical School, São Paulo, Brazil
| | - Lampros K Michalis
- Michaelidion Cardiac Center and Department of Cardiology, Medical School, University of Ioannina, GR 45110, Ioannina, Greece
| | - Oberdan Parodi
- Michaelidion Cardiac Center and Department of Cardiology, Medical School, University of Ioannina, GR 45110, Ioannina, Greece
| | - Federico Vozzi
- Institute of Clinical Physiology, National Research Council, Pisa, IT 56124, Italy
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO Box 1186, GR 45110, Ioannina, Greece. .,FORTH-Institute of Molecular Biology and Biotechnology, Department of Biomedical Research, GR 45110, Ioannina, Greece. .,Michaelidion Cardiac Center and Department of Cardiology, Medical School, University of Ioannina, GR 45110, Ioannina, Greece.
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