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Barkas F, Sener YZ, Golforoush PA, Kheirkhah A, Rodriguez-Sanchez E, Novak J, Apellaniz-Ruiz M, Akyea RK, Bianconi V, Ceasovschih A, Chee YJ, Cherska M, Chora JR, D'Oria M, Demikhova N, Kocyigit Burunkaya D, Rimbert A, Macchi C, Rathod K, Roth L, Sukhorukov V, Stoica S, Scicali R, Storozhenko T, Uzokov J, Lupo MG, van der Vorst EPC, Porsch F. Advancements in risk stratification and management strategies in primary cardiovascular prevention. Atherosclerosis 2024; 395:117579. [PMID: 38824844 DOI: 10.1016/j.atherosclerosis.2024.117579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 06/04/2024]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality worldwide, highlighting the urgent need for advancements in risk assessment and management strategies. Although significant progress has been made recently, identifying and managing apparently healthy individuals at a higher risk of developing atherosclerosis and those with subclinical atherosclerosis still poses significant challenges. Traditional risk assessment tools have limitations in accurately predicting future events and fail to encompass the complexity of the atherosclerosis trajectory. In this review, we describe novel approaches in biomarkers, genetics, advanced imaging techniques, and artificial intelligence that have emerged to address this gap. Moreover, polygenic risk scores and imaging modalities such as coronary artery calcium scoring, and coronary computed tomography angiography offer promising avenues for enhancing primary cardiovascular risk stratification and personalised intervention strategies. On the other hand, interventions aiming against atherosclerosis development or promoting plaque regression have gained attention in primary ASCVD prevention. Therefore, the potential role of drugs like statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, omega-3 fatty acids, antihypertensive agents, as well as glucose-lowering and anti-inflammatory drugs are also discussed. Since findings regarding the efficacy of these interventions vary, further research is still required to elucidate their mechanisms of action, optimize treatment regimens, and determine their long-term effects on ASCVD outcomes. In conclusion, advancements in strategies addressing atherosclerosis prevention and plaque regression present promising avenues for enhancing primary ASCVD prevention through personalised approaches tailored to individual risk profiles. Nevertheless, ongoing research efforts are imperative to refine these strategies further and maximise their effectiveness in safeguarding cardiovascular health.
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Affiliation(s)
- Fotios Barkas
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
| | - Yusuf Ziya Sener
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Azin Kheirkhah
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elena Rodriguez-Sanchez
- Division of Cardiology, Department of Medicine, Department of Physiology, and Molecular Biology Institute, UCLA, Los Angeles, CA, USA
| | - Jan Novak
- 2(nd) Department of Internal Medicine, St. Anne's University Hospital in Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic; Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Maria Apellaniz-Ruiz
- Genomics Medicine Unit, Navarra Institute for Health Research - IdiSNA, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Ralph Kwame Akyea
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, United Kingdom
| | - Vanessa Bianconi
- Department of Medicine and Surgery, University of Perugia, Italy
| | - Alexandr Ceasovschih
- Internal Medicine Department, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Ying Jie Chee
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - Mariia Cherska
- Cardiology Department, Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | - Joana Rita Chora
- Unidade I&D, Grupo de Investigação Cardiovascular, Departamento de Promoção da Saúde e Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; Universidade de Lisboa, Faculdade de Ciências, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Nadiia Demikhova
- Sumy State University, Sumy, Ukraine; Tallinn University of Technology, Tallinn, Estonia
| | | | - Antoine Rimbert
- Nantes Université, CNRS, INSERM, l'institut du Thorax, Nantes, France
| | - Chiara Macchi
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università Degli Studi di Milano, Milan, Italy
| | - Krishnaraj Rathod
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Barts Interventional Group, Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Vasily Sukhorukov
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - Svetlana Stoica
- "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; Institute of Cardiovascular Diseases Timisoara, Timisoara, Romania
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Tatyana Storozhenko
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Prevention and Treatment of Emergency Conditions, L.T. Malaya Therapy National Institute NAMSU, Kharkiv, Ukraine
| | - Jamol Uzokov
- Republican Specialized Scientific Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan
| | | | - Emiel P C van der Vorst
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52074, Aachen, Germany; Aachen-Maastricht Institute for CardioRenal Disease (AMICARE), RWTH Aachen University, 52074, Aachen, Germany; Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-University Munich, 80336, Munich, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH Aachen University, 52074, Aachen, Germany
| | - Florentina Porsch
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
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2
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Kimura M, Takeda T, Tsujino Y, Matsumoto Y, Yamaji M, Sakaguchi T, Maeda K, Mabuchi H, Murakami T. Assessing the efficacy of saline flush in frequency-domain optical coherence tomography for intracoronary imaging. Heart Vessels 2024; 39:310-318. [PMID: 38062328 PMCID: PMC10920414 DOI: 10.1007/s00380-023-02340-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/08/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND The increased amount of contrast media in frequency-domain optical coherence tomography (FD-OCT) imaging during percutaneous coronary intervention (PCI) has raised potential concerns regarding impairment of renal function. OBJECTIVES This study aimed to evaluate the effectiveness of heparinized saline flush in FD-OCT-guided PCI and identify clinical factors contributing to optimal image quality. METHODS We retrospectively collected 100 lesions from 90 consecutive patients, and a total of 200 pullbacks were analyzed for the initial and final evaluation in which saline was used as the flushing medium. RESULTS The study population had a mean age of 73, with 52% having chronic kidney disease (CKD). The median amount of contrast used was 28 ml, and no complications were observed associated with saline flush OCT. Imaging quality was then categorized as excellent, good, or unacceptable. Among the total runs, 87% demonstrated clinically acceptable image quality, with 66.5% classified as excellent images and 20.5% classified as good images. Independent predictors of excellent images included lumen area stenosis ≥ 70% (adjusted odds ratio [OR] 2.37, 95% confidence interval [CI] 1.02-5.47, P = 0.044), and the use of intensive flushing (adjusted OR 2.06, 95% CI 1.11-3.86, P = 0.023) defined as a deep engagement of guiding catheter (GC) or a selective insertion of guide extension catheter (GE). Intensive flushing was performed in 60% of the total pullbacks, and it was particularly effective in improving image quality in the left coronary artery (LCA). CONCLUSION The use of saline flush during FD-OCT imaging was safe and feasible, which had a benefit in renal protection with adequate imaging quality.
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Affiliation(s)
- Masahiro Kimura
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan.
| | - Teruki Takeda
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Yasushi Tsujino
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Yuichi Matsumoto
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Masayuki Yamaji
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Tomoko Sakaguchi
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Keiko Maeda
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Hiroshi Mabuchi
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Tomoyuki Murakami
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
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3
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Asghari H. Visible wavelength time-stretch optical coherence tomography. OPTICS EXPRESS 2023; 31:24085-24096. [PMID: 37475244 DOI: 10.1364/oe.492753] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/21/2023] [Indexed: 07/22/2023]
Abstract
Visible light optical coherence tomography (OCT) is an emerging non-invasive imaging modality that offers new opportunities for anatomical and functional imaging of biological tissues. Time-stretch dispersive Fourier transform, also known as photonic time-stretch, is an all-optical processing method that enables real-time Fourier transformation of ultrafast optical signals and allows for OCT at high A-scan rates. In this work, a working prototype of a photonic time-stretch OCT (TS-OCT) method in the visible wavelength region is proposed and experimentally demonstrated. The proposed visible-light TS-OCT system achieves unprecedented throughput of 100 giga voxels/second and OCT volume rate of 4,000 volumes/second and can be used to expand the range of applications of TS-OCT systems.
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Wang Z, Xie R, Shi Q, Li Y, Chang J, Yuan J, Gong H, Chen J. Vacuum-assisted tissue embedding for whole-heart imaging. BIOMEDICAL OPTICS EXPRESS 2023; 14:2539-2550. [PMID: 37342702 PMCID: PMC10278630 DOI: 10.1364/boe.488766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 06/23/2023]
Abstract
The use of combined optical imaging and tissue sectioning has potential for use in visualizing heart-wide fine structures at single-cell resolution. However, existing tissue preparation methods fail to generate ultrathin cavity-containing cardiac tissue slices with minimal deformation. This study developed an efficient vacuum-assisted tissue embedding method to prepare high-filled, agarose-embedded whole-heart tissue. Utilizing optimized vacuum parameters, we achieved 94% filled whole-heart tissue with the thinnest cut slice of 5 µm. We subsequently imaged a whole mouse heart sample using vibratome-integrated fluorescence micro-optical sectioning tomography (fMOST) with a voxel size of 0.32 µm × 0.32 µm × 1 µm. The imaging results indicated that the vacuum-assisted embedding method enabled whole-heart tissue to withstand long-term thin cutting while ensuring that slices were consistent and of high quality.
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Affiliation(s)
- Zhi Wang
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, China
- HUST-Suzhou Institute for Brainsmatics, JITRI, Suzhou, China
| | - Ruiheng Xie
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, China
| | - Qishuo Shi
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, China
| | - Yafeng Li
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, China
| | - Jin Chang
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Yuan
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, China
- HUST-Suzhou Institute for Brainsmatics, JITRI, Suzhou, China
| | - Hui Gong
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, China
- HUST-Suzhou Institute for Brainsmatics, JITRI, Suzhou, China
| | - Jianwei Chen
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, China
- HUST-Suzhou Institute for Brainsmatics, JITRI, Suzhou, China
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5
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Fitzgerald S, Akhtar J, Schartner E, Ebendorff-Heidepriem H, Mahadevan-Jansen A, Li J. Multimodal Raman spectroscopy and optical coherence tomography for biomedical analysis. JOURNAL OF BIOPHOTONICS 2023; 16:e202200231. [PMID: 36308009 PMCID: PMC10082563 DOI: 10.1002/jbio.202200231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Optical techniques hold great potential to detect and monitor disease states as they are a fast, non-invasive toolkit. Raman spectroscopy (RS) in particular is a powerful label-free method capable of quantifying the biomolecular content of tissues. Still, spontaneous Raman scattering lacks information about tissue morphology due to its inability to rapidly assess a large field of view. Optical Coherence Tomography (OCT) is an interferometric optical method capable of fast, depth-resolved imaging of tissue morphology, but lacks detailed molecular contrast. In many cases, pairing label-free techniques into multimodal systems allows for a more diverse field of applications. Integrating RS and OCT into a single instrument allows for both structural imaging and biochemical interrogation of tissues and therefore offers a more comprehensive means for clinical diagnosis. This review summarizes the efforts made to date toward combining spontaneous RS-OCT instrumentation for biomedical analysis, including insights into primary design considerations and data interpretation.
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Affiliation(s)
- Sean Fitzgerald
- Vanderbilt Biophotonics Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jobaida Akhtar
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Erik Schartner
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Heike Ebendorff-Heidepriem
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Anita Mahadevan-Jansen
- Vanderbilt Biophotonics Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jiawen Li
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, South Australia, Australia
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6
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Li J, Centurion F, Chen R, Gu Z. Intravascular Imaging of Atherosclerosis by Using Engineered Nanoparticles. BIOSENSORS 2023; 13:319. [PMID: 36979531 PMCID: PMC10046792 DOI: 10.3390/bios13030319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Atherosclerosis is a leading cause of morbidity and mortality, and high-risk atherosclerotic plaques can result in myocardial infarction, stroke, and/or sudden death. Various imaging and sensing techniques (e.g., ultrasound, optical coherence tomography, fluorescence, photoacoustic) have been developed for scanning inside blood vessels to provide accurate detection of high-risk atherosclerotic plaques. Nanoparticles have been utilized in intravascular imaging to enable targeted detection of high-risk plaques, to enhance image contrast, and in some applications to also provide therapeutic functions of atherosclerosis. In this paper, we review the recent progress on developing nanoparticles for intravascular imaging of atherosclerosis. We discuss the basic nanoparticle design principles, imaging modalities and instrumentations, and common targets for atherosclerosis. The review is concluded and highlighted with discussions on challenges and opportunities for bringing nanoparticles into in vivo (pre)clinical intravascular applications.
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Affiliation(s)
- Jiawen Li
- School of Electrical and Mechanical Engineering, University of Adelaide, Adelaide, SA 5005, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, SA 5005, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Franco Centurion
- School of Chemical Engineering, University of New South Wales, Sydney, NSW 2052, Australia
| | - Rouyan Chen
- School of Electrical and Mechanical Engineering, University of Adelaide, Adelaide, SA 5005, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Zi Gu
- School of Chemical Engineering, University of New South Wales, Sydney, NSW 2052, Australia
- Australian Centre for NanoMedicine (ACN), University of New South Wales, Sydney, NSW 2052, Australia
- UNSW RNA Institute, University of New South Wales, Sydney, NSW 2052, Australia
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7
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Cheng E, Jennings RN, Chen CL, Biggo MR, Erickson AK, Dornbusch JA, Linn SC, Lapsley J, Alva BM, Lorbach JN, Premanandan C, Selmic LE. Optical coherence tomography for surgical margin evaluation of excised canine cutaneous and subcutaneous tumours. Vet Comp Oncol 2022; 20:836-845. [PMID: 35662386 PMCID: PMC9796844 DOI: 10.1111/vco.12844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/15/2022] [Accepted: 06/01/2022] [Indexed: 01/07/2023]
Abstract
Currently, intraoperative tumour margin imaging is not routinely utilized in veterinary medicine. Optical coherence tomography (OCT) allows for real-time assessment of tissue morphology of 1-2 mm depth. The aims of this study were (1) to compare the histologic and OCT features of excised canine skin and subcutaneous specimens, and (2) to determine the diagnostic accuracy of OCT for surgical margin evaluation. The authors hypothesized that OCT imaging would correlate well with histopathology and that OCT would be sensitive for detection of incomplete margins. Eighty dogs were prospectively enrolled. Tumours were excised, and the surgical margins were imaged using a spectral domain OCT system. The tumour type and completeness of excision were determined by histopathology. Nine blinded observers received training in OCT image interpretation and were then given a set of OCT images and videos. The observers assigned each image/video a grade from 1 (no tumour) to 4 (tumour) and the results were compared to histopathology. The overall median sensitivity and specificity of OCT imaging for detection of incomplete margins were 86.7% and 84.6%, respectively. A potential limitation is that observers had varied experience with OCT image interpretation, ranging from no prior experience to participating in a previous OCT project. OCT is sensitive for detection of incomplete margins and could be a promising real-time surgical margin imaging modality. Further study is needed to evaluate intraoperative applications of OCT and its impact on tumour recurrence and long-term outcome.
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Affiliation(s)
- Edward Cheng
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Ryan N. Jennings
- Department of Veterinary Biosciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Carolyn L. Chen
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Morgan R. Biggo
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Andrea K. Erickson
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Josephine A. Dornbusch
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Sarah C. Linn
- Department of Veterinary Biosciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Janis Lapsley
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Bianca M. Alva
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Joshua N. Lorbach
- Department of Veterinary Biosciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Christopher Premanandan
- Department of Veterinary Biosciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Laura E. Selmic
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
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8
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Dawson LP, Layland J. High-Risk Coronary Plaque Features: A Narrative Review. Cardiol Ther 2022; 11:319-335. [PMID: 35731471 PMCID: PMC9381667 DOI: 10.1007/s40119-022-00271-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022] Open
Abstract
Advances in coronary plaque imaging over the last few decades have led to an increased interest in the identification of novel high-risk plaque features that are associated with cardiovascular events. Existing practices focus on risk stratification and lipid monitoring for primary and secondary prevention of cardiac events, which is limited by a lack of assessment and treatment of vulnerable plaque. In this review, we summarize the multitude of studies that have identified plaque, haemodynamic and patient factors associated with risk of acute coronary syndrome. Future progress in multi-modal imaging strategies and in our understanding of high-risk plaque features could expand treatment options for coronary disease and improve patient outcomes.
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Affiliation(s)
- Luke P Dawson
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Cardiology, The Alfred Hospital, Melbourne, VIC, Australia
| | - Jamie Layland
- Department of Medicine, Monash University, Clayton campus, Melbourne, VIC, Australia. .,Department of Cardiology, Peninsula Health, 2 Hastings Rd, Frankston, VIC, 3199, Australia.
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Taguchi Y, Itoh T, Sasaki W, Oda H, Uchimura Y, Kaneko K, Sakamoto T, Goto I, Sakuma M, Ishida M, Terashita D, Otake H, Morino Y, Shinke T. Predictors of Irregular Protrusion After Everolimus-Eluting Stent Implantation in Patients with Stable Coronary Artery Disease. Int Heart J 2022; 63:210-216. [PMID: 35354743 DOI: 10.1536/ihj.21-548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study aimed to investigate clinical and preintervention optical coherence tomography (OCT) findings to predict irregular protrusion (IRP) immediately after stent implantation.We evaluated 84 lesions treated with cobalt-chromium everolimus-eluting stent (CoCr-EES) from the MECHANISM Elective study. Patients were divided into two groups according to the presence of IRP [IRP: n = 16, non-IRP: n = 68]. Optical coherence tomography images before intervention and immediately after stenting were evaluated with standard qualitative and quantitative OCT analyses.Total cholesterol and the prevalence of ruptured plaque before intervention were significantly higher in the IRP group than in the non-IRP group [199 ± 37 mg/dL versus 176 ± 41 mg/dL; P = 0.022, 31% versus 7%; P = 0.008]. Total lipid length tended to be longer in the IRP group than in the non-IRP group [19.6 ± 9.2 mm versus 15.5 ± 9.3 mm; P = 0.090]. The prevalence of ruptured plaque, and total cholesterol levels were independent predictors of IRP immediately after stenting by multivariate logistic regression analysis [OR: 4.6, 95% confidence interval: 1.01-21.23, P = 0.048, OR: 1.02, 95% confidence interval: 1.00-1.03, P = 0.046]. IRP post-CoCr-EES implantation was completely resolved at follow-up OCT.The prevalence of ruptured plaque before intervention and total cholesterol levels were independent predictors of IRP after CoCr-EES implantation in patients with stable coronary artery disease.
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Affiliation(s)
- Yuya Taguchi
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Tomonori Itoh
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Wataru Sasaki
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Hideto Oda
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Yohei Uchimura
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Kyosuke Kaneko
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Tsubasa Sakamoto
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Iwao Goto
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Masafumi Sakuma
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Masaru Ishida
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Daisuke Terashita
- Division of Cardiology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hiromasa Otake
- Division of Cardiology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yoshihiro Morino
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Toshiro Shinke
- Division of Cardiovascular Medicine, Department of Internal Medicine, Showa University School of Medicine
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10
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Crean A, Benson L, Shah A, Han K, Lesser J, McCrindle BW. Imaging the delayed complications of childhood Kawasaki disease. F1000Res 2022; 11:147. [PMID: 36970577 PMCID: PMC10036956 DOI: 10.12688/f1000research.73097.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/20/2022] Open
Abstract
This review will discuss the long-term complications of Kawasaki disease with a particular focus on imaging surveillance of the coronary arteries in adolescence and adult life. The relative advantages and disadvantages of each modality will be illustrated with practical examples, demonstrating that, in many cases, a multimodality imaging strategy may be required.
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Affiliation(s)
- Andrew Crean
- Cardiology, University of Ottawa Heart Institute, Ottawa, ON, K1Y 4W7, Canada
| | - Lee Benson
- Cardiology, Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
| | - Ashish Shah
- Cardiology, St Boniface Hospital, Winnipeg, Manitoba, R2H 2A6, Canada
| | - Kelly Han
- Cardiology, Children's Minnesota Hospital, Minneapolis, MN, 55404, USA
| | - John Lesser
- Cardiology, Minneapolis Heart Institute, Minneapolis, MN, 55407, USA
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11
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Li J, Shang C, Rong Y, Sun J, Cheng Y, He B, Wang Z, Li M, Ma J, Fu B, Ji X. Review on Laser Technology in Intravascular Imaging and Treatment. Aging Dis 2022; 13:246-266. [PMID: 35111372 PMCID: PMC8782552 DOI: 10.14336/ad.2021.0711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/11/2021] [Indexed: 12/14/2022] Open
Abstract
Blood vessels are one of the most essential organs, which nourish all tissues in our body. Once there are intravascular plaques or vascular occlusion, other organs and circulatory systems will not work properly. Therefore, it is necessary to detect abnormal blood vessels by intravascular imaging technologies for subsequent vascular treatment. The emergence of lasers and fiber optics promotes the development of intravascular imaging and treatment. Laser imaging techniques can obtain deep vascular images owing to light scattering and absorption properties. Moreover, photothermal and photomechanical effects of laser make it possible to treat vascular diseases accurately. In this review, we present the research progress and applications of laser techniques in intravascular imaging and treatment. Firstly, we introduce intravascular optical coherent tomography and intravascular photoacoustic imaging, which can obtain various information of plaques. Multimodal intravascular imaging techniques provide more information about intravascular plaques, which have an essential influence on intravascular imaging. Secondly, two laser techniques including laser angioplasty and endovenous laser ablation are discussed for the treatment of arterial and venous diseases, respectively. Finally, the outlook of laser techniques in blood vessels, as well as the integration of laser imaging and treatment are prospected in the section of discussions.
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Affiliation(s)
- Jing Li
- BUAA-CCMU Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China.
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
| | - Ce Shang
- BUAA-CCMU Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China.
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
| | - Yao Rong
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
- Medical Engineering Devices of Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Jingxuan Sun
- BUAA-CCMU Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China.
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
| | - Yuan Cheng
- BUAA-CCMU Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China.
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
| | - Boqu He
- BUAA-CCMU Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China.
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
| | - Zihao Wang
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
| | - Ming Li
- China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Jianguo Ma
- BUAA-CCMU Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China.
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
| | - Bo Fu
- BUAA-CCMU Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China.
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
- Key Laboratory of Big Data-Based Precision Medicine Ministry of Industry and Information Technology, Interdisciplinary Innovation Institute of Medicine and Engineering, Beihang University, Beijing, China.
| | - Xunming Ji
- BUAA-CCMU Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China.
- China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Neurosurgery Department of Xuanwu Hospital, Capital Medical University, Beijing, China.
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12
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Portable, handheld, and affordable blood perfusion imager for screening of subsurface cancer in resource-limited settings. Proc Natl Acad Sci U S A 2022; 119:2026201119. [PMID: 34983869 PMCID: PMC8764675 DOI: 10.1073/pnas.2026201119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 12/11/2022] Open
Abstract
Existing procedures of screening subsurface cancers are either prohibitively resource-intensive and expensive or are unable to provide direct quantitative estimates of the relevant physiological parameters for accurate classification accommodating interpatient variabilities and overlapping clinical manifestations. Here, we introduce a handheld and inexpensive blood perfusion imager that provides a noninvasive in situ screening approach for distinguishing precancer, cancer, and normal scenarios by precise quantitative estimation of the localized blood circulation in the tissue over an unrestricted region of interest without any unwarranted noise in the data, augmented by machine learning–based classification. Clinical trials in minimally resourced settings have established the efficacy of the method in differentiating cancerous and precancerous stages of suspected oral abnormalities, as verified by gold-standard biopsy reports. Precise information on localized variations in blood circulation holds the key for noninvasive diagnostics and therapeutic assessment of various forms of cancer. While thermal imaging by itself may provide significant insights on the combined implications of the relevant physiological parameters, viz. local blood perfusion and metabolic balance due to active tumors as well as the ambient conditions, knowledge of the tissue surface temperature alone may be somewhat inadequate in distinguishing between some ambiguous manifestations of precancer and cancerous lesions, resulting in compromise of the selectivity in detection. This, along with the lack of availability of a user-friendly and inexpensive portable device for thermal-image acquisition, blood perfusion mapping, and data integration acts as a deterrent against the emergence of an inexpensive, contact-free, and accurate in situ screening and diagnostic approach for cancer detection and management. Circumventing these constraints, here we report a portable noninvasive blood perfusion imager augmented with machine learning–based quantitative analytics for screening precancerous and cancerous traits in oral lesions, by probing the localized alterations in microcirculation. With a proven overall sensitivity >96.66% and specificity of 100% as compared to gold-standard biopsy-based tests, the method successfully classified oral cancer and precancer in a resource-limited clinical setting in a double-blinded patient trial and exhibited favorable predictive capabilities considering other complementary modes of medical image analysis as well. The method holds further potential to achieve contrast-free, accurate, and low-cost diagnosis of abnormal microvascular physiology and other clinically vulnerable conditions, when interpreted along with complementary clinically evidenced decision-making perspectives.
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13
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Dawson LP, Lum M, Nerleker N, Nicholls SJ, Layland J. Coronary Atherosclerotic Plaque Regression: JACC State-of-the-Art Review. J Am Coll Cardiol 2022; 79:66-82. [PMID: 34991791 DOI: 10.1016/j.jacc.2021.10.035] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022]
Abstract
Over the last 3 decades there have been substantial improvements in treatments aimed at reducing cardiovascular (CV) events. As these treatments have been developed, there have been parallel improvements in coronary imaging modalities that can assess plaque volumes and composition, using both invasive and noninvasive techniques. Plaque progression can be seen to precede CV events, and therefore, many studies have longitudinally assessed changes in plaque characteristics in response to various treatments, aiming to demonstrate plaque regression and improvements in high-risk features, with the rationale being that this will reduce CV events. In the past, decisions surrounding treatments for atherosclerosis have been informed by population-based risk scores for initiation in primary prevention and low-density lipoprotein cholesterol levels for titration in secondary prevention. If outcome data linking plaque regression to reduced CV events emerge, it may become possible to directly image plaque treatment response to guide management decisions.
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Affiliation(s)
- Luke P Dawson
- Department of Cardiology, Peninsula Health, Victoria, Australia; Monash University, Melbourne, Victoria, Australia; Department of Cardiology, The Royal Melbourne Hospital, Victoria, Australia; Department of Cardiology, The Alfred Hospital, Victoria, Australia
| | - Mark Lum
- Monash University, Melbourne, Victoria, Australia
| | - Nitesh Nerleker
- Monash University, Melbourne, Victoria, Australia; Department of Cardiology, Monash Health, Clayton, Victoria, Australia; The Baker Institute, Melbourne, Victoria, Australia
| | - Stephen J Nicholls
- Monash University, Melbourne, Victoria, Australia; Department of Cardiology, Monash Health, Clayton, Victoria, Australia
| | - Jamie Layland
- Department of Cardiology, Peninsula Health, Victoria, Australia; Monash University, Melbourne, Victoria, Australia.
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14
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Reddy SA, Khialani BV, Lambert B, Floré V, Brown AJ, Pettit SJ, West NE, Lewis C, Parameshwar J, Bhagra S, Kydd A, Hoole SP. Coronary imaging of cardiac allograft vasculopathy predicts current and future deterioration of left ventricular function in patients with orthotopic heart transplantation. Clin Transplant 2021; 36:e14523. [PMID: 34724254 DOI: 10.1111/ctr.14523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/19/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) improve sensitivity of cardiac allograft vasculopathy (CAV) detection compared to invasive coronary angiography (ICA), but their ability to predict clinical events is unknown. We determined whether severe CAV detected with ICA, IVUS, or OCT correlates with graft function. METHODS Comparison of specific vessel parameters between IVUS and OCT on 20 patients attending for angiography 12-24 months post-orthotopic heart transplant. Serial left ventricular ejection fraction (EF) was recorded prospectively. RESULTS Analyzing 55 coronary arteries, OCT and IVUS correlated well for vessel CAV characteristics. A mean intimal thickness (MIT)OCT > .25 mm had a sensitivity of 86.7% and specificity of 74.3% at detecting Stanford grade 4 CAV. Those with angiographically evident CAV had significant reduction in graft EF over 7.3 years follow-up (median ΔEF -2% vs +1.5%, P = .03). Patients with MITOCT > .25 mm in at least one vessel had a lower median EF at time of surveillance (57% vs 62%, P = .014). Two MACEs were noted. CONCLUSION Imaging with OCT correlates well with IVUS for CAV detection. Combined angiography and OCT to screen for CAV within 12-24 months of transplant predicts concurrent and future deterioration in graft function.
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Affiliation(s)
- S Ashwin Reddy
- Department of Interventional Cardiology, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Bharat V Khialani
- Department of Interventional Cardiology, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Ben Lambert
- Department of Interventional Cardiology, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Vintcent Floré
- Department of Interventional Cardiology, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Adam J Brown
- Department of Interventional Cardiology, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Steve J Pettit
- Transplant Unit, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Nick Ej West
- Department of Interventional Cardiology, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Clive Lewis
- Transplant Unit, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Jayan Parameshwar
- Transplant Unit, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Sai Bhagra
- Transplant Unit, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Anna Kydd
- Transplant Unit, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
| | - Stephen P Hoole
- Department of Interventional Cardiology, Cambridge Biomedical Campus, Royal Papworth Hospital, Cambridge, UK
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15
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Li L, Zhao L, Wang J, Li Z, Shi Y, Wang G, Yan B, Wang Z, Shi H, Zhao N, Liu B. Optical coherence tomography-guided drug coated balloon in non-small de novo coronary artery lesions: a prospective clinical research. Am J Transl Res 2021; 13:11617-11624. [PMID: 34786087 PMCID: PMC8581893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE The combined use of drug coated balloon (DCB) and optical coherence tomography (OCT) for the treatment of non-small coronary de novo lesion remains to be evaluated. We investigated the safety and efficacy of OCT-guided DCB in non-small coronary de novo lesion patients with predilation of cutting balloon. METHODS https://clinicaltrials.gov/, ClinicalTrials.gov Identifier: NCT04795144. This study was a prospective, and open-label study. We enrolled patients with non-small de novo lesions treated with OCT-guided DCB. The non-small de novo lesions indicated vessel lesions with a diameter ≥ 2.5 mm. The primary endpoints were the success rate of the procedure and the occurrence of target lesion revascularization. The secondary endpoints were myocardial infarction, cardiac death, and major adverse cardiac events (MACE) within 3 months after the procedure. RESULTS At the Second Hospital of Jilin University, we enrolled 54 patients (54 lesions) with non-small de novo lesions who were treated with OCT-guided DCB from October 2018 to June 2019. A total of 52 patients were successfully treated with DCB-only strategy, while 2 patients turned to bailout stenting. A total of 21 patients had undergone angiography 3 months after the procedure with the late lumen loss of 0.24±0.57 mm. There was no statistically significant difference in minimal lumen diameter (MLD) between post-DCB and at 3-month angiographic follow-up (2.25±0.40 mm vs 2.04±0.54 mm; P = 0.110). Only 1 patient developed restenosis with the incidence of MACE rate of only 1.92% (n = 1). There was no significant difference in the stenosis of the lumen diameter of the target lesion vessel between 3 months after operation and immediately after operation. CONCLUSIONS Our study showed that OCT-guided DCB with cutting balloon under guidance may be a novel approach in non-small de novo coronary artery disease.
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Affiliation(s)
- Longbo Li
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Lei Zhao
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Jinpeng Wang
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Zhibo Li
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Yongfeng Shi
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Guan Wang
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Bing Yan
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Zhihui Wang
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Henghe Shi
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Ning Zhao
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
| | - Bin Liu
- Department of Cardiology, The Second Hospital of Jilin University Changchun 130000, Jilin, China
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16
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Blanco PJ, Bulant CA, Ares GD, Lemos PA, Feijóo RA. A simple coronary blood flow model to study the collateral flow index. Biomech Model Mechanobiol 2021; 20:1365-1382. [PMID: 33772676 DOI: 10.1007/s10237-021-01449-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/06/2021] [Indexed: 11/25/2022]
Abstract
In this work, we present a novel modeling framework to investigate the effects of collateral circulation into the coronary blood flow physiology. A prototypical model of the coronary tree, integrated with the concept of Collateral Flow Index (CFI), is employed to gain insight about the role of model parameters associated with the collateral circuitry, which results in physically-realizable solutions for specific CFI data. Then, we discuss the mathematical feasibility of pressure-derived CFI, anatomical implications and practical considerations involving the estimation of model parameters in collateral connections. A sensitivity analysis is carried out, and the investigation of the impact of the collateral circulation on FFR values is also addressed.
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Affiliation(s)
- Pablo J Blanco
- Laboratório Nacional de Computação Científica, Av. Getúlio Vargas 333, Petrópolis, 25651-075, Brazil.
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil.
| | - Carlos A Bulant
- National University of the Center and National Scientific and Technical Research Council, CONICET, Tandil, Argentina
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
| | - Gonzalo D Ares
- National University of Mar del Plata, Mar del Plata, Argentina
| | - Pedro A Lemos
- Hospital Israelita Albert Einstein., São Paulo, Brazil
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
| | - Raúl A Feijóo
- Laboratório Nacional de Computação Científica, Av. Getúlio Vargas 333, Petrópolis, 25651-075, Brazil
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
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17
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Osborn EA, Albaghdadi M, Libby P, Jaffer FA. Molecular Imaging of Atherosclerosis. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00086-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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18
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Yu B, Dong B, He J, Huang H, Huang J, Wang Y, Liang J, Zhang J, Qiu Y, Shen J, Shuai X, Tao J, Xia W. Bimodal Imaging-Visible Nanomedicine Integrating CXCR4 and VEGFa Genes Directs Synergistic Reendothelialization of Endothelial Progenitor Cells. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2020; 7:2001657. [PMID: 33344118 PMCID: PMC7740091 DOI: 10.1002/advs.202001657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/08/2020] [Indexed: 06/01/2023]
Abstract
A major challenge to treat vascular endothelial injury is the restoration of endothelium integrity in which endothelial progenitor cells (EPCs) plays a central role. Transplantation of EPCs as a promising therapeutic means is subject to two interrelated processes, homing and differentiation of EPCs in vivo, and thus a lack of either one may greatly affect the outcome of EPC-based therapy. Herein, a polymeric nanocarrier is applied for the codelivery of CXCR4 and VEGFa genes to simultaneously promote the migration and differentiation of EPCs. Moreover, MRI T2 contrast agent SPION and NIR dye Cy7.5 are also loaded into the nanocarrier in order to track EPCs in vivo. Based on the synergistic effect of the two codelivered genes, an improved reendothelialization of EPCs is achieved in a rat carotid denuded model. The results show the potential of this bimodal imaging-visible nanomedicine to improve the performance of EPCs in repairing arterial injury, which may push forward the stem cell-based therapy of cardiovascular disease.
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Affiliation(s)
- Bingbo Yu
- Department of Hypertension and Vascular DiseaseThe First Affiliated Hospital of Sun Yat‐sen UniversityNational‐Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular DiseasesKey Laboratory on Assisted CirculationMinistry of HealthGuangzhou510080China
| | - Bing Dong
- Department of Hypertension and Vascular DiseaseThe First Affiliated Hospital of Sun Yat‐sen UniversityNational‐Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular DiseasesKey Laboratory on Assisted CirculationMinistry of HealthGuangzhou510080China
| | - Jiang He
- Department of Hypertension and Vascular DiseaseThe First Affiliated Hospital of Sun Yat‐sen UniversityNational‐Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular DiseasesKey Laboratory on Assisted CirculationMinistry of HealthGuangzhou510080China
| | - Hui Huang
- Department of CardiovascularThe Eighth Affiliated Hospital of Sun Yat‐sen UniversityShenzhen518000China
| | - Jinsheng Huang
- PCFM Lab of Ministry of EducationSchool of Material Science and EngineeringSun Yat‐sen UniversityGuangzhou510275China
| | - Yong Wang
- PCFM Lab of Ministry of EducationSchool of Material Science and EngineeringSun Yat‐sen UniversityGuangzhou510275China
| | - Jianwen Liang
- Department of CardiovascularThe Eighth Affiliated Hospital of Sun Yat‐sen UniversityShenzhen518000China
| | - Jianning Zhang
- Department of Hypertension and Vascular DiseaseThe First Affiliated Hospital of Sun Yat‐sen UniversityNational‐Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular DiseasesKey Laboratory on Assisted CirculationMinistry of HealthGuangzhou510080China
| | - Yumin Qiu
- Department of Hypertension and Vascular DiseaseThe First Affiliated Hospital of Sun Yat‐sen UniversityNational‐Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular DiseasesKey Laboratory on Assisted CirculationMinistry of HealthGuangzhou510080China
| | - Jun Shen
- Department of RadiologySun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhou510120China
| | - Xintao Shuai
- Department of Hypertension and Vascular DiseaseThe First Affiliated Hospital of Sun Yat‐sen UniversityNational‐Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular DiseasesKey Laboratory on Assisted CirculationMinistry of HealthGuangzhou510080China
- PCFM Lab of Ministry of EducationSchool of Material Science and EngineeringSun Yat‐sen UniversityGuangzhou510275China
| | - Jun Tao
- Department of Hypertension and Vascular DiseaseThe First Affiliated Hospital of Sun Yat‐sen UniversityNational‐Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular DiseasesKey Laboratory on Assisted CirculationMinistry of HealthGuangzhou510080China
| | - Wenhao Xia
- Department of Hypertension and Vascular DiseaseThe First Affiliated Hospital of Sun Yat‐sen UniversityNational‐Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular DiseasesKey Laboratory on Assisted CirculationMinistry of HealthGuangzhou510080China
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19
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Otsuka K, Villiger M, Nadkarni SK, Bouma BE. Intravascular Polarimetry: Clinical Translation and Future Applications of Catheter-Based Polarization Sensitive Optical Frequency Domain Imaging. Front Cardiovasc Med 2020; 7:146. [PMID: 33005632 PMCID: PMC7485575 DOI: 10.3389/fcvm.2020.00146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
Optical coherence tomography (OCT) and optical frequency domain imaging (OFDI) visualize the coronary artery wall and plaque morphology in great detail. The advent of these high-resolution intracoronary imaging modalities has propelled our understanding of coronary atherosclerosis and provided enhanced guidance for percutaneous coronary intervention. Yet, the lack of contrast between distinct tissue types and plaque compositions impedes further elucidation of the complex mechanisms that contribute to acute coronary syndrome (ACS) and hinders the prospective identification of plaques susceptible to rupture. Intravascular polarimetry with polarization-sensitive OFDI measures polarization properties of the coronary arterial wall using conventional intravascular imaging catheters. The quantitative polarization metrics display notable image contrast between several relevant coronary plaque microstructures that are difficult to identify with conventional OCT and OFDI. Tissues rich in collagen and smooth muscle cells exhibit birefringence, while lipid and macrophages cause depolarization. In this review, we describe the basic principles of intravascular polarimetry, discuss the interpretation of the polarization signatures, and outline promising avenues for future research and clinical implications.
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Affiliation(s)
- Kenichiro Otsuka
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Martin Villiger
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Seemantini K Nadkarni
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Brett E Bouma
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
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20
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Mahesh NK, Gupta A, Barward P, Vijayvergiya R, Sharma P, Mahesh A. Study of saline optical coherence tomography-guided percutaneous coronary intervention (SOCT-PCI Study). Indian Heart J 2020; 72:239-243. [PMID: 32861376 PMCID: PMC7474129 DOI: 10.1016/j.ihj.2020.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/01/2020] [Accepted: 03/28/2020] [Indexed: 11/29/2022] Open
Abstract
AIM The aim of this study was to evaluate the feasibility of heparinised saline as flushing media for frequency-domain optical coherence tomography (FD-OCT) image acquisition during percutaneous coronary intervention (PCI) optimisation. METHODS AND RESULTS Twenty-seven patients undergoing FD-OCT-guided PCI were enrolled. Heparinised saline was injected into the coronary during FD-OCT image acquisition. A total of 118 runs were analysed for image quality and diagnostic value. FD-OCT runs were categorised as follows: good runs (GRs), clinically usable runs (CURs) and clinically not usable runs (NURs); GRs and CURs were combined as clinically effective runs (ERs). Saline FD-OCT enabled visualisation of all possible coronary lesions. Of the 118 runs analysed, 61%, 27.1%, 11.9% and 88.1% were GRs, CURs, NURs and ERs, respectively. Sixty-one percent of total runs were left coronary system (LCS) and 39% were right coronary system (RCS) runs. Among LCS runs, 55.6%, 30.6%, 13.8% and 86.2% were GRs, CURs, NURs and ERs, respectively. Among RCS runs, 69.6%, 21.7%, 8.7% and 91.3% were GRs, CURs, NURs and ERs, respectively. CONCLUSION This is the first study to demonstrate the technical feasibility of isolated saline FD-OCT for PCI optimisation.
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Affiliation(s)
- Nalin K Mahesh
- Department of Cardiology, Base Hospital Delhi Cantt, New Delhi, India
| | - Ankush Gupta
- Department of Cardiology, Base Hospital Delhi Cantt, New Delhi, India.
| | | | | | - Prafull Sharma
- Department of Cardiology, Base Hospital Delhi Cantt, New Delhi, India
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21
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Rafalsky VV, Zyubin AY, Moiseeva EM, Samusev IG. Prospects for Raman spectroscopy in cardiology. ACTA ACUST UNITED AC 2020. [DOI: 10.15829/1728-8800-2020-1-2394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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Otsuka K, Villiger M, Nadkarni SK, Bouma BE. Intravascular Polarimetry for Tissue Characterization of Coronary Atherosclerosis. Circ Rep 2019; 1:550-557. [PMID: 32432174 PMCID: PMC7236778 DOI: 10.1253/circrep.cr-19-0102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 01/20/2023] Open
Abstract
The microscopic tissue structure and organization influence the polarization of light. Intravascular polarimetry leverages this compelling intrinsic contrast mechanism by using polarization-sensitive optical frequency domain imaging to measure the polarization properties of the coronary arterial wall. Tissues rich in collagen and smooth muscle cells appear birefringent, while the presence of lipid causes depolarization, offering quantitative metrics related to the presence of important components of coronary atherosclerosis. Here, we review the basic principle, the interpretation of polarization signatures, and first clinical investigations of intravascular polarimetry and discuss how this extension of contemporary intravascular imaging may advance our knowledge and improve clinical practice in the future.
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Affiliation(s)
- Kenichiro Otsuka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Seemantini K Nadkarni
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Brett E Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, United States
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23
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Leiner T. Detecting coronary plaque vulnerability using computed tomography radiomics: the one stop shop for plaque vulnerability? Eur Heart J Cardiovasc Imaging 2019; 20:1248-1249. [PMID: 31005961 DOI: 10.1093/ehjci/jez071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Tim Leiner
- Utrecht University Medical Center, Department of Radiology, E.01.132, Heidelberglaan 100, Utrecht, The Netherlands
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24
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Paraggio L, Burzotta F, Aurigemma C, Scalise R, Leone AM, Niccoli G, Porto I, Genuardi L, Dato I, Trani C, Crea F. Trends and outcomes of optical coherence tomography use: 877 patients single-center experience. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2019; 20:303-310. [DOI: 10.1016/j.carrev.2018.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/07/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
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25
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Romagnoli E, Gatto L, Prati F. The CLIMA study: assessing the risk of myocardial infarction with a new anatomical score. Eur Heart J Suppl 2019; 21:B80-B83. [PMID: 30948958 PMCID: PMC6439910 DOI: 10.1093/eurheartj/suz032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Atherosclerosis is a chronic degenerative disease, with a significant inflammatory component, characterized by phases of rapid activation leading to important clinical events, such as myocardial infarction. One of the major challenges of modern cardiology is limiting the progression of atherosclerotic disease and anticipating the phases of instability as to limit its consequences. In this contest modern techniques of intra-coronary imaging, such as optical coherence tomography, could have a pivotal role in identifying patients at higher risk of acute events in the short term. The purpose of the CLIMA study is to identify and map the vulnerability criteria of atherosclerotic coronary plaques in the individual patient, and provide a personalized risk score for coronary events.
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Affiliation(s)
| | - Laura Gatto
- Ospedale San Giovanni-Addolorata, Rome, Italy.,Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy
| | - Francesco Prati
- Ospedale San Giovanni-Addolorata, Rome, Italy.,Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy
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26
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Law TSM, Cheung WC, Wu F, Zhang R, Chung JPW, Wang CC, Chen X, Li TC. Endometrial Vascularization Characterized by Optical Coherence Tomography and Immunohistochemistry in Women Undergoing In Vitro Fertilization-Embryo Transfer Treatment. ACTA ACUST UNITED AC 2019; 55:medicina55040081. [PMID: 30934763 PMCID: PMC6524031 DOI: 10.3390/medicina55040081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/25/2019] [Accepted: 03/25/2019] [Indexed: 12/12/2022]
Abstract
Background and objective: Endometrial angiogenesis is a prerequisite for successful pregnancy. Optical coherence tomography (OCT) is a non-invasive physically optical imaging technique widely used in ophthalmology and cardiology. However, there is no study using OCT to evaluate endometrium. The aim of this study was to use OCT and traditionally histological methods to investigate endometrial vascularization in women undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment and to determine the association with the pregnancy outcome. Methods: A total of 47 women were included in this study. OCT was used to assess endometrial vascularization by determining the high signal areas precisely on the seventh day after luteinizing hormone surge in non-conception natural cycles. Endometrial biopsies were obtained following OCT and immunohistochemistry was used to determine micro vessel and expression of vascular endothelial growth factor-A (VEGF-A) in the luminal epithelium, glandular epithelium and stroma, separately. Micro vessel counting was performed and the result was expressed as micro vessel density (MVD). A semi-quantitative H-score was used to determine the staining intensity of VEGF-A. Results: In women who successfully conceived after embryo transfer, the proportion of extensive high signal area in the uterine body detected by OCT (80%, 8/10), MVD (median number of micro vessels/mm2 of 10, range 4–17) and stromal expression of VEGF-A (median H-score of 189, range 72–395) were found to be significantly higher than those of women who did not conceive after embryo transfer in the subsequent IVF-ET treatment (OCT: 30%, 3/10; MVD: median number of micro vessels/mm2 of 7, range 4–10; VEGF-A: median H-score of 125, range 86–299, respectively). In addition, a significantly higher stromal expression of VEGF-A (median H-score of 196, range 84–395) and MVD (median number of micro vessels/mm2 of 9, range 5–16) was found in women with extensive high signal area in uterine body, compared to those with focal or no high signal area (stromal VEGF-A: median H-score of 135, range 92–302; MVD: number of micro vessels/mm2 of 6, range 4-11). Conclusions: Both immunohistochemistry and OCT demonstrated significant difference in vascularization of the peri-implantation endometrium between subjects who did and did not conceive after IVF-ET treatment. Our findings also suggest OCT appears to be a promising non-invasive or minimally invasive alternative to study endometrial vascularity in women with reproductive failure.
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Affiliation(s)
- Tracy Sze Man Law
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Wing Ching Cheung
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Fangrong Wu
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Ruizhe Zhang
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Jacqueline Pui Wah Chung
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Chi Chiu Wang
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong.
- School of Biomedical Science, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Xiaoyan Chen
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Tin Chiu Li
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
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27
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Elliott MR, Kim D, Molony DS, Morris L, Samady H, Joshi S, Timmins LH. Establishment of an Automated Algorithm Utilizing Optical Coherence Tomography and Micro-Computed Tomography Imaging to Reconstruct the 3-D Deformed Stent Geometry. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:710-720. [PMID: 30843790 PMCID: PMC6407623 DOI: 10.1109/tmi.2018.2870714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Percutaneous coronary intervention (PCI) is the prevalent treatment for coronary artery disease, with hundreds of thousands of stents implanted annually. Computational studies have demonstrated the role of biomechanics in the failure of vascular stents, but clinical studies is this area are limited by a lack of understanding of the deployed stent geometry, which is required to accurately model and predict the stent-induced in vivo biomechanical environment. Herein, we present an automated method to reconstruct the 3-D deployed stent configuration through the fusion of optical coherence tomography (OCT) and micro-computed tomography ( μ CT) imaging data. In an experimental setup, OCT and μ CT data were collected in stents deployed in arterial phantoms ( n=4 ). A constrained iterative deformation process directed by diffeomorphic metric mapping was developed to deform μ CT data of a stent wireframe to the OCT-derived sparse point cloud of the deployed stent. Reconstructions of the deployed stents showed excellent agreement with the ground-truth configurations, with the distance between corresponding points on the reconstructed and ground-truth configurations of [Formula: see text]. Finally, reconstructions required <30 min of computational time. In conclusion, the developed and validated reconstruction algorithm provides a complete spatially resolved reconstruction of a deployed vascular stent from commercially available imaging modalities and has the potential, with further development, to provide more accurate computational models to evaluate the in vivo post-stent mechanical environment, as well as clinical visualization of the 3-D stent geometry immediately following PCI.
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28
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Polycythemia Vera Presenting as Cardiac Arrest: Novel Management Strategies. Case Rep Cardiol 2019; 2019:9656387. [PMID: 30805220 PMCID: PMC6362489 DOI: 10.1155/2019/9656387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/02/2018] [Accepted: 01/03/2019] [Indexed: 11/18/2022] Open
Abstract
Acute coronary syndromes (ACS) usually occur in patients with multiple cardiac risk factors. In young adults, drug use and hypercoagulable states are common causes for ACS presentations. We report a case of a man in his early 30s who was diagnosed with polycythemia vera (PV) and had a cardiac arrest due to an anterolateral ST elevation myocardial infarction. We discuss his unique management and review the evidence on the management of arterial thromboembolism in PV patients.
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29
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Su M, Zhang Z, Hong J, Huang Y, Mu P, Yu Y, Liu R, Liang S, Zheng H, Qiu W. Cable shared dual-frequency catheter for intravascular ultrasound. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:849-856. [PMID: 30762542 DOI: 10.1109/tuffc.2019.2898256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study proposes a catheter consisting of dual-frequency transducer for intravascular ultrasound. Both ultrasonic elements with different frequencies were connected to one coaxial cable to make the connection simple. The aperture size of the ultrasound elements were 0.4×0.6 mm2 and 0.3×0.4 mm2 for the low frequency element and high frequency element, respectively. The center frequency and bandwidth of the fabricated low frequency transducer were 33.8 MHz and 49.3%, respectively. Meanwhile, the center frequency and bandwidth of the high frequency transducer were 80.6 MHz and 50.3%, respectively. Imaging evaluations of wire phantom, tissue phantom and vessel tissue demonstrated good imaging capability of the dual-frequency catheter. The spatial resolution are 19 μm axially and 128 μm laterally for the high frequency transducer, and 37 μm axially and 199 μm laterally for the low frequency transducer. Band-pass filters were designed to separate the mixed echo signals. After filtering, the images from different ultrasound elements can be successfully identified, indicating the feasibility of the proposed cable shared dual-frequency imaging strategy. The proposed method has simple structure, good imaging resolution, and large penetration depth, showing good application prospect for intravascular ultrasound.
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30
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Lee HD, Kim GH, Shin JG, Lee B, Kim CS, Eom TJ. Akinetic swept-source optical coherence tomography based on a pulse-modulated active mode locking fiber laser for human retinal imaging. Sci Rep 2018; 8:17660. [PMID: 30518926 PMCID: PMC6281618 DOI: 10.1038/s41598-018-36252-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/15/2018] [Indexed: 01/09/2023] Open
Abstract
Optical coherence tomography (OCT) is a noninvasive imaging modality that can provide high-resolution, cross-sectional images of tissues. Especially in retinal imaging, OCT has become one of the most valuable imaging tools for diagnosing eye diseases. Considering the scattering and absorption properties of the eye, the 1000-nm OCT system is preferred for retinal imaging. In this study, we describe the use of an akinetic swept-source OCT system based on a pulse-modulated active mode locking (AML) fiber laser at a 1080-nm wavelength for in-vivo human retinal imaging. The akinetic AML wavelength-swept fiber laser was constructed with polarization-maintaining fiber that has an average linewidth of 0.625 nm, a spectral bandwidth of 81.15 nm, and duty ratio of 90% without the buffering method. We successfully obtained in-vivo human retinal images using the proposed OCT system without the additional k-clock and the frequency shifter that provides a wide field of view of 43.1°. The main retina layers, such as the retinal pigment epithelium, can be distinguished from the OCT image with an axial resolution of 6.3 μm with this OCT system.
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Affiliation(s)
- Hwi Don Lee
- Advanced Photonics Research Institute, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea
| | - Gyeong Hun Kim
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan, 46241, South Korea
| | - Jun Geun Shin
- Advanced Photonics Research Institute, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea
| | - Boram Lee
- Department of ophthalmology, Korea University college of medicine, Seoul, 02841, South Korea
| | - Chang-Seok Kim
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan, 46241, South Korea.
| | - Tae Joong Eom
- Advanced Photonics Research Institute, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea.
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31
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Ramakonar H, Quirk BC, Kirk RW, Li J, Jacques A, Lind CRP, McLaughlin RA. Intraoperative detection of blood vessels with an imaging needle during neurosurgery in humans. SCIENCE ADVANCES 2018; 4:eaav4992. [PMID: 30585293 PMCID: PMC6300404 DOI: 10.1126/sciadv.aav4992] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/20/2018] [Indexed: 05/05/2023]
Abstract
Intracranial hemorrhage can be a devastating complication associated with needle biopsies of the brain. Hemorrhage can occur to vessels located adjacent to the biopsy needle as tissue is aspirated into the needle and removed. No intraoperative technology exists to reliably identify blood vessels that are at risk of damage. To address this problem, we developed an "imaging needle" that can visualize nearby blood vessels in real time. The imaging needle contains a miniaturized optical coherence tomography probe that allows differentiation of blood flow and tissue. In 11 patients, we were able to intraoperatively detect blood vessels (diameter, >500 μm) with a sensitivity of 91.2% and a specificity of 97.7%. This is the first reported use of an optical coherence tomography needle probe in human brain in vivo. These results suggest that imaging needles may serve as a valuable tool in a range of neurosurgical needle interventions.
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Affiliation(s)
- Hari Ramakonar
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Bryden C. Quirk
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Rodney W. Kirk
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Jiawen Li
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Angela Jacques
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Christopher R. P. Lind
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Robert A. McLaughlin
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
- Corresponding author.
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32
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Zeng Y, Zhu J, Wang J, Parasuraman P, Busi S, Nauli SM, Wáng YXJ, Pala R, Liu G. Functional probes for cardiovascular molecular imaging. Quant Imaging Med Surg 2018; 8:838-852. [PMID: 30306063 PMCID: PMC6177368 DOI: 10.21037/qims.2018.09.19] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/17/2018] [Indexed: 12/26/2022]
Abstract
Cardiovascular diseases (CVDs) are a severely threatening disorder and frequently cause death in industrialized countries, posing critical challenges to modern research and medicine. Molecular imaging has been heralded as the solution to many problems encountered in individuals living with CVD. The use of probes in cardiovascular molecular imaging is causing a paradigmatic shift from regular imaging techniques, to future advanced imaging technologies, which will facilitate the acquisition of vital information at the cellular and molecular level. Advanced imaging for CVDs will help early detection of disease development, allow early therapeutic intervention, and facilitate better understanding of fundamental biological processes. To promote a better understanding of cardiovascular molecular imaging, this article summarizes the current developments in the use of molecular probes, highlighting some of the recent advances in probe design, preparation, and functional modification.
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Affiliation(s)
- Yun Zeng
- Department of Pharmacology, Xiamen Medical College, Xiamen 361008, China
| | - Jing Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Junqing Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Paramanantham Parasuraman
- Departments of Microbiology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
| | - Siddhardha Busi
- Departments of Microbiology, School of Life Sciences, Pondicherry University, Puducherry 605014, India
| | - Surya M. Nauli
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, California, USA
| | - Yì Xiáng J. Wáng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Rajasekharreddy Pala
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, California, USA
| | - Gang Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
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33
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Mathews SJ, Little C, Loder CD, Rakhit RD, Xia W, Zhang EZ, Beard PC, Finlay MC, Desjardins AE. All-optical dual photoacoustic and optical coherence tomography intravascular probe. PHOTOACOUSTICS 2018; 11:65-70. [PMID: 30112279 PMCID: PMC6092552 DOI: 10.1016/j.pacs.2018.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 05/09/2023]
Abstract
Intravascular imaging in percutaneous coronary interventions can be an invaluable tool in the treatment of coronary artery disease. It is of significant interest to provide molecular imaging contrast that is complementary to structural contrast provided by optical coherence tomography (OCT) and intravascular ultrasound imaging (IVUS). In this study, we developed a dual-modality intravascular imaging probe comprising a commercial OCT catheter and a high sensitivity fiber optic ultrasound sensor, to provide both photoacoustic (PA) and OCT imaging. With PA imaging, the lateral resolution varied from 18 μm to 40 μm; the axial resolution was consistently in the vicinity of 45 μm. We demonstrated the clinical potential of the probe with 2-D circumferential PA and OCT imaging, and with multispectral PA imaging.
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Affiliation(s)
- Sunish J. Mathews
- Department of Medical Physics and Biomedical Engineering, University College London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
| | - Callum Little
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
- Department of Cardiology, Royal Free Hospital, London, UK
| | | | - Roby D. Rakhit
- Department of Cardiology, Royal Free Hospital, London, UK
| | - Wenfeng Xia
- Department of Medical Physics and Biomedical Engineering, University College London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
| | - Edward Z. Zhang
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - Paul C. Beard
- Department of Medical Physics and Biomedical Engineering, University College London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
| | - Malcolm C. Finlay
- Department of Medical Physics and Biomedical Engineering, University College London, UK
- William Harvey Cardiovascular Research Institute, Queen Mary University of London, UK
- Barts Heart Centre, London, UK
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, UK
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34
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Integrating optical coherence tomography with gravimetric and video analysis (OCT-Gravimetry-Video method) for studying the drying process of polystyrene latex system. Sci Rep 2018; 8:12962. [PMID: 30154524 PMCID: PMC6113323 DOI: 10.1038/s41598-018-30914-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 08/03/2018] [Indexed: 12/12/2022] Open
Abstract
Latex, an aqueous dispersion of sub-micron polymer particles, is widely used as polymer binder in waterborne coatings and adhesives. Drying of a latex is inhomogeneous, during which the spatial distribution of particles is non-uniform and changes with time, usually resulting in a compromise of the integrity of a dried film. To study drying inhomogeneity of latex, we developed a system integrating optical coherence tomography (OCT) with gravimetric and video analysis (OCT-Gravimetry-Video method) to non-destructively monitor the drying process of non-film-forming latexes consisting of hard polystyrene spheres over time. OCT structural and speckle images of the latex’s internal structure show the packing process of particles, the detachment of latex and the formation of apparent shear bands in cross-sectional views. Video recordings show the formation of cracks and the propagation of the drying boundary in the horizontal direction. The drying curve, measured by gravimetry, shows the drying rate and the water content of the latex at each drying stage. Furthermore, we find that the particle size affects packing and cracking phenomena remarkably. The OCT-Gravimetry-Video method serves as a general and robust approach to investigate the drying process of waterborne latex system. This method can be employed for fundamental studies of colloids and for evaluations of industrial latex products.
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35
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Munding CE, Chérin E, Jourard I, Weyers JJ, Goertz DE, Courtney BK, Foster FS. Development of a 3 French Dual-Frequency Intravascular Ultrasound Catheter. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:251-266. [PMID: 29150363 DOI: 10.1016/j.ultrasmedbio.2017.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/13/2017] [Accepted: 09/18/2017] [Indexed: 05/25/2023]
Abstract
Coronary plaque morphology, including plaque size and fibrous cap thickness, is thought to contribute to the risk of plaque rupture and future cardiac events. Dual-frequency intravascular ultrasound has been proposed as a possible technique to visualize both large-scale features and superficial detail of coronary plaque; however, it has not been found to be feasible within the constraints of a clinically functional intravascular ultrasound catheter. In this study, we describe the design and fabrication of a dual-frequency catheter using a bidirectional transducer stack with center frequencies of approximately 30 and 80 MHz. We describe how the high-frequency transducer achieves significantly improved axial and lateral resolution (16 and 120 µm, respectively, vs. 50 and 220 µm) at the expense of penetration depth. Finally, imaging of ex vivo human coronary artery segments reveals that the catheter can provide complementary images of the deeper arterial wall and superficial plaque features.
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Affiliation(s)
- Chelsea E Munding
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
| | | | - Isaac Jourard
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Jill J Weyers
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - David E Goertz
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Brian K Courtney
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Conavi Medical Inc., Toronto, Ontario, Canada
| | - F Stuart Foster
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada
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36
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MacRitchie N, Grassia G, Noonan J, Garside P, Graham D, Maffia P. Molecular imaging of atherosclerosis: spotlight on Raman spectroscopy and surface-enhanced Raman scattering. Heart 2017; 104:460-467. [PMID: 29061690 PMCID: PMC5861389 DOI: 10.1136/heartjnl-2017-311447] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 01/03/2023] Open
Abstract
To accurately predict atherosclerotic plaque progression, a detailed phenotype of the lesion at the molecular level is required. Here, we assess the respective merits and limitations of molecular imaging tools. Clinical imaging includes contrast-enhanced ultrasound, an inexpensive and non-toxic technique but with poor sensitivity. CT benefits from high spatial resolution but poor sensitivity coupled with an increasing radiation burden that limits multiplexing. Despite high sensitivity, positron emission tomography and single-photon emission tomography have disadvantages when applied to multiplex molecular imaging due to poor spatial resolution, signal cross talk and increasing radiation dose. In contrast, MRI is non-toxic, displays good spatial resolution but poor sensitivity. Preclinical techniques include near-infrared fluorescence (NIRF), which provides good spatial resolution and sensitivity; however, multiplexing with NIRF is limited, due to photobleaching and spectral overlap. Fourier transform infrared spectroscopy and Raman spectroscopy are label-free techniques that detect molecules based on the vibrations of chemical bonds. Both techniques offer fast acquisition times with Raman showing superior spatial resolution. Raman signals are inherently weak; however, leading to the development of surface-enhanced Raman spectroscopy (SERS) that offers greatly increased sensitivity due to using metallic nanoparticles that can be functionalised with biomolecules targeted against plaque ligands while offering high multiplexing potential. This asset combined with high spatial resolution makes SERS an exciting prospect as a diagnostic tool. The ongoing refinements of SERS technologies such as deep tissue imaging and portable systems making SERS a realistic prospect for translation to the clinic.
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Affiliation(s)
- Neil MacRitchie
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,British Society for Cardiovascular Research, UK
| | - Gianluca Grassia
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jonathan Noonan
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,British Society for Cardiovascular Research, UK
| | - Paul Garside
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Duncan Graham
- Centre for Molecular Nanometrology, Department of Pure and Applied Chemistry, University of Strathclyde, Glasgow, UK
| | - Pasquale Maffia
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,British Society for Cardiovascular Research, UK.,Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Department of Pharmacy, University of Naples Federico II, Naples, Italy
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37
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Savastano LE, Seibel EJ. Scanning Fiber Angioscopy: A Multimodal Intravascular Imaging Platform for Carotid Atherosclerosis. Neurosurgery 2017; 64:188-198. [PMID: 28899060 DOI: 10.1093/neuros/nyx322] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 08/01/2017] [Indexed: 01/28/2023] Open
Affiliation(s)
- Luis E Savastano
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Eric J Seibel
- Department of Mechanical Engineering, University of Washington, Seattle, Washington
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38
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Bourantas CV, Crake T, Zhang YJ, Ozkor M, Ahmed J, Garcia-Garcia HM, Serruys PW. Intravascular imaging in cardiovascular ageing. Exp Gerontol 2017; 109:31-37. [PMID: 28522312 DOI: 10.1016/j.exger.2017.05.011] [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: 03/12/2017] [Revised: 04/19/2017] [Accepted: 05/14/2017] [Indexed: 11/16/2022]
Abstract
Ageing is related to complex molecular, inflammatory and biochemical changes that affect coronary pathology and often lead to coronary artery disease and cardiovascular events. Intravascular imaging is considered as the ideal technique to study coronary plaque morphology and assess its burden. Over the recent years several studies have been performed that investigated the association between pathophysiological mechanisms that promote vascular ageing and plaque morphology. In addition, several reports have compared plaque pathology in different age groups and a few studies included serial intravascular imaging to assess changes in the atheroma burden and compositional characteristics of the plaque. This review article summarizes the evidence derived from intravascular imaging studies about the implications of vascular ageing on coronary artery morphology and discusses the potential of coronary imaging in assessing atherosclerotic evolution.
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Affiliation(s)
- Christos V Bourantas
- Barts Heart Centre, Barts Health NHS Trust, London, UK; Institute of Cardiovascular Sciences, University College London, London, UK.
| | - Tom Crake
- Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Yao-Jun Zhang
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Mick Ozkor
- Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Javed Ahmed
- Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Patrick W Serruys
- Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands; International Centre for Circulatory Health, NHLI, Imperial College London, London, UK
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39
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Intravascular endoscopy improvement through narrow-band imaging. Int J Comput Assist Radiol Surg 2017; 12:2015-2021. [PMID: 28361325 PMCID: PMC5656714 DOI: 10.1007/s11548-017-1579-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/21/2017] [Indexed: 12/13/2022]
Abstract
Purpose Recent advances in endoscopy have led to new technologies with significant optical imaging improvements. Since its development a few years ago, narrow-band imaging (NBI) has already been proved useful in detecting malignant lesions and carcinoma in clinical settings of urology, gastroenterology and ENT. The potential of this technology for imaging applications of the arterial vessel wall has not been properly analysed yet, but with the observed benefits could prove valuable for this clinical use as well. Methods In order to assess the efficacy of NBI, defects such as burns and mechanical tears were created on the walls of an arterial vessel sample. Ex vivo imaging using NBI and white light imaging (WLI) were performed with rigid and flexible fibre endoscopes. Results A thorough comparison of the images proved that NBI enhances the visualisation of lesions and defects on the artery walls compared to normal WLI. Conclusion WLI provides a direct image of the vessel lumen and its anatomical shape. It is suitable for observation and documentation of intravascular therapies. NBI images are more distinct and have more contrast. This helps to detect even small defects or changes on the inner vessel wall that could provide additional information and lead to more precise and personalised therapies.
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40
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Baumann B, Woehrer A, Ricken G, Augustin M, Mitter C, Pircher M, Kovacs GG, Hitzenberger CK. Visualization of neuritic plaques in Alzheimer's disease by polarization-sensitive optical coherence microscopy. Sci Rep 2017; 7:43477. [PMID: 28262719 PMCID: PMC5337955 DOI: 10.1038/srep43477] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/24/2017] [Indexed: 12/16/2022] Open
Abstract
One major hallmark of Alzheimer's disease (AD) and cerebral amyloid angiopathy (CAA) is the deposition of extracellular senile plaques and vessel wall deposits composed of amyloid-beta (Aβ). In AD, degeneration of neurons is preceded by the formation of Aβ plaques, which show different morphological forms. Most of them are birefringent owing to the parallel arrangement of amyloid fibrils. Here, we present polarization sensitive optical coherence microscopy (PS-OCM) for imaging mature neuritic Aβ plaques based on their birefringent properties. Formalin-fixed, post-mortem brain samples of advanced stage AD patients were investigated. In several cortical brain regions, neuritic Aβ plaques were successfully visualized in tomographic and three-dimensional (3D) images. Cortical grey matter appeared polarization preserving, whereas neuritic plaques caused increased phase retardation. Consistent with the results from PS-OCM imaging, the 3D structure of senile Aβ plaques was computationally modelled for different illumination settings and plaque sizes. Furthermore, the birefringent properties of cortical and meningeal vessel walls in CAA were investigated in selected samples. Significantly increased birefringence was found in smaller vessels. Overall, these results provide evidence that PS-OCM is able to assess amyloidosis based on intrinsic birefringent properties.
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Affiliation(s)
- Bernhard Baumann
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, A-1090, Vienna, Austria
| | - Adelheid Woehrer
- General Hospital and Medical University of Vienna, Institute of Neurology, A-1090, Vienna, Austria
| | - Gerda Ricken
- General Hospital and Medical University of Vienna, Institute of Neurology, A-1090, Vienna, Austria
| | - Marco Augustin
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, A-1090, Vienna, Austria
| | - Christian Mitter
- General Hospital and Medical University of Vienna, Institute of Neurology, A-1090, Vienna, Austria
- General Hospital and Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, A-1090, Vienna, Austria
| | - Michael Pircher
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, A-1090, Vienna, Austria
| | - Gabor G. Kovacs
- General Hospital and Medical University of Vienna, Institute of Neurology, A-1090, Vienna, Austria
| | - Christoph K. Hitzenberger
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, A-1090, Vienna, Austria
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41
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Prati F, Romagnoli E, Gatto L, La Manna A, Burzotta F, Limbruno U, Versaci F, Fabbiocchi F, Di Giorgio A, Marco V, Ramazzotti V, Di Vito L, Trani C, Porto I, Boi A, Tavazzi L, Mintz GS. Clinical Impact of Suboptimal Stenting and Residual Intrastent Plaque/Thrombus Protrusion in Patients With Acute Coronary Syndrome. Circ Cardiovasc Interv 2016; 9:CIRCINTERVENTIONS.115.003726. [DOI: 10.1161/circinterventions.115.003726] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 11/13/2016] [Indexed: 12/27/2022]
Abstract
Background—
Clinical consequences of optical coherence tomographic (OCT) high-definition visualization of plaque/stent structures in acute patients remain undefined. In this retrospective substudy, we assessed the prognostic impact of postprocedural culprit lesion OCT findings in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
Methods and Results—
In the CLI-OPCI (Centro per la Lotta Contro L’Infarto-Optimization of Percutaneous Coronary Intervention) database collecting cases from 5 independent OCT-experienced centers, we retrospectively analyzed postprocedural OCT findings in acute coronary syndrome patients and explored its possible impact (specifically that of residual intrastent plaque/thrombus protrusion) on outcome. From 2009 to 2013, 507 patients (588 lesions) were evaluated. Patients experiencing device-oriented cardiovascular events showed more frequently the features of suboptimal stent implantation defined as the presence of significant residual intrastent plaque/thrombus protrusion (hazard ratio [HR], 2.35;
P
<0.01), in-stent minimum lumen area (MLA) <4.5 mm
2
(HR, 2.72;
P
<0.01), dissection >200 µm at distal stent edge (HR, 3.84;
P
<0.01), and reference lumen area <4.5 mm
2
at either distal (HR, 6.07;
P
<0.001) or proximal (HR, 8.50;
P
<0.001) stent edges. Postprocedural OCT assessment of treated culprit lesion revealed at least one of these parameters in 55.2% of cases, with an associated increased risk of device-oriented cardiovascular events during follow-up (17.9% versus 4.8%;
P
<0.001). Both the presence of at least one of these parameters (HR, 3.69;
P
=0.002) and the residual intrastent plaque/thrombus protrusion (HR, 2.83;
P
=0.008) were confirmed as independent predictors of device-oriented cardiovascular events.
Conclusions—
In this retrospective study of acute coronary syndrome patients undergoing percutaneous coronary intervention, a composite of OCT-defined suboptimal stent implantation characteristics at the culprit lesion and residual intrastent plaque/thrombus protrusion was associated with adverse outcome.
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Affiliation(s)
- Francesco Prati
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Enrico Romagnoli
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Laura Gatto
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Alessio La Manna
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Francesco Burzotta
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Ugo Limbruno
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Francesco Versaci
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Franco Fabbiocchi
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Alessandro Di Giorgio
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Valeria Marco
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Vito Ramazzotti
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Luca Di Vito
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Carlo Trani
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Italo Porto
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Alberto Boi
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Luigi Tavazzi
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
| | - Gary S. Mintz
- From the Division of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy (F.P., L.G., V.R., L.D.V.); Centro per la Lotta Contro L’Infarto–CLI Foundation, Rome, Italy (F.P., E.R., L.G., A.D.G., V.M.); Division of Cardiology, University of Catania, Italy (A.L.M.); Cardiovascular Department, Università Cattolica Del Sacro Cuore, Rome, Italy (F.B., C.T., I.P.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (U.L.); Division of Cardiology, Ospedale Civile Ferdinando Veneziale,
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42
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Hayat U, Thondapu V, Tsay T, Barlis P. Atherogenesis and Inflammation. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Umair Hayat
- Melbourne Medical School; The University of Melbourne; Australia
| | - Vikas Thondapu
- Melbourne Medical School; The University of Melbourne; Australia
| | - Tim Tsay
- Melbourne Medical School; The University of Melbourne; Australia
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Blachutzik F, Achenbach S, Nef H, Hamm C, Dörr O, Boeder N, Marwan M, Tröbs M, Schneider R, Röther J, Schlundt C. Optical coherence tomography: influence of contrast concentration on image quality and diagnostic confidence. Heart Vessels 2016; 32:653-659. [PMID: 27830336 DOI: 10.1007/s00380-016-0918-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 11/04/2016] [Indexed: 12/13/2022]
Abstract
OCT requires intracoronary injection of contrast agent to remove blood from the coronary lumen during data acquisition, which is a possible limitation of this method. Aim of this study was to analyze the influence of iodine concentration on image quality and diagnostic certainty of optical coherence tomography (OCT). OCT sequences acquired using contrast agent with a reduced concentration of 150 mg iodine/ml and a standard concentration of 350 mg iodine/ml were analyzed. Cross-sectional images with a spacing of 10 mm were evaluated regarding image quality and diagnostic confidence. A total of 67 OCT sequences acquired in 24 patients were analyzed. 31 sequences were acquired using contrast agent with a concentration of 150 mg iodine/ml and 36 sequences with a concentration of 350 mg iodine/ml. The percentage of remaining blood streaks in the cross sections was significantly lower for 350 mg iodine/ml compared to 150 mg iodine/ml (19 ± 21 vs. 34 ± 26%, p = 0.013). Contrast with 350 mg iodine/ml showed a significantly higher percentage of completely flushed pullback length as compared to 150 mg iodine/ml (78 ± 24 vs. 58 ± 27%, p = 0.004). Diagnostic certainty was significantly higher for 350 mg iodine/ml than for 150 mg iodine/ml (Likert scale average 1.4 ± 0.7 vs. 2.1 ± 1.2, p < 0.001; Likert scale: 1 = absolutely confident, 2 = confident with slight doubts, 3 = doubtful/not confident, 4 = non-diagnostic). Regarding image quality and diagnostic certainty, contrast agent with a concentration of 350 mg iodine/ml is superior to 150 mg iodine/ml.
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Affiliation(s)
- Florian Blachutzik
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.
| | - Stephan Achenbach
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Holger Nef
- Department of Cardiology, University Hospital Giessen, Giessen, Germany
| | - Christian Hamm
- Department of Cardiology, University Hospital Giessen, Giessen, Germany
| | - Oliver Dörr
- Department of Cardiology, University Hospital Giessen, Giessen, Germany
| | - Niklas Boeder
- Department of Cardiology, University Hospital Giessen, Giessen, Germany
| | - Mohamed Marwan
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Monique Tröbs
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Reinhard Schneider
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Jens Röther
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Christian Schlundt
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
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44
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Gubarkova EV, Dudenkova VV, Feldchtein FI, Timofeeva LB, Kiseleva EB, Kuznetsov SS, Shakhov BE, Moiseev AA, Gelikonov VM, Gelikonov GV, Vitkin A, Gladkova ND. Multi-modal optical imaging characterization of atherosclerotic plaques. JOURNAL OF BIOPHOTONICS 2016; 9:1009-1020. [PMID: 26604168 DOI: 10.1002/jbio.201500223] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/01/2015] [Accepted: 11/04/2015] [Indexed: 05/08/2023]
Abstract
We combined cross-polarization optical coherence tomography (CP OCT) and non-linear microscopy based on second harmonic generation (SHG) and two-photon-excited fluorescence (2PEF) to assess collagen and elastin fibers and other vascular structures in the development of atherosclerosis, including identification of vulnerable plaques, which remains an important clinical problem and imaging application. CP OCT's ability to visualize tissue birefringence and cross-scattering adds new information about the microstructure and composition of the plaque. However its interpretation can be ambiguous, because backscattering contrast may have a similar appearance to the birefringence related fringes. Our results represent a step towards minimally invasive characterization and monitoring of different stages of atherosclerosis, including vulnerable plaques. CP OCT image of intimal thickening in the human coronary artery. The dark stripe in the cross-polarization channel (arrow) is a polarization fringe related to the phase retardation between two eigen polarization states. It is histologically located in the area of the lipid pool, however this stripe is a polarization artifact, rather than direct visualization of the lipid pool.
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Affiliation(s)
- Ekaterina V Gubarkova
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia.
| | - Varvara V Dudenkova
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia
- N.I. Lobachevsky State University of Nizhny Novgorod, 603950, 23 Gagarin St., Nizhny Novgorod, Russia
| | - Felix I Feldchtein
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia
| | - Lidia B Timofeeva
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia
| | - Elena B Kiseleva
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia
| | - Sergei S Kuznetsov
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia
| | - Boris E Shakhov
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia
| | - Alexander A Moiseev
- Institute of Applied Physics RAS, 603950 Ulyanov St., 46, Nizhny Novgorod, Russia
| | - Valentin M Gelikonov
- Institute of Applied Physics RAS, 603950 Ulyanov St., 46, Nizhny Novgorod, Russia
| | - Gregory V Gelikonov
- Institute of Applied Physics RAS, 603950 Ulyanov St., 46, Nizhny Novgorod, Russia
| | - Alex Vitkin
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia
- Departments of Medical Biophysics and Radiation Oncology, University of Toronto, Ontario, M5G 2M9, Canada
- Ontario Cancer Institute, University Health Network, Toronto, Ontario, M5G 2M9, Canada
| | - Natalia D Gladkova
- Nizhny Novgorod State Medical Academy, 603005 Minin and Pozharsky Sq., 10/1, Nizhny Novgorod, Russia
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45
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Prati F, Romagnoli E, Burzotta F, Limbruno U, Gatto L, La Manna A, Versaci F, Marco V, Di Vito L, Imola F, Paoletti G, Trani C, Tamburino C, Tavazzi L, Mintz GS. Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study. JACC Cardiovasc Imaging 2016; 8:1297-305. [PMID: 26563859 DOI: 10.1016/j.jcmg.2015.08.013] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/04/2015] [Accepted: 08/06/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The goal of this study was to assess the clinical impact of optical coherence tomography (OCT) findings during percutaneous coronary intervention (PCI). BACKGROUND OCT provides unprecedented high-definition visualization of plaque/stent structures during PCI; however, the impact of OCT findings on outcome remains undefined. METHODS In the context of the multicenter CLI-OPCI (Centro per la Lotta contro l'Infarto-Optimisation of Percutaneous Coronary Intervention) registry, we retrospectively analyzed patients undergoing end-procedural OCT assessment and compared the findings with clinical outcomes. RESULTS A total of 1,002 lesions (832 patients) were assessed. Appropriate OCT assessment was obtained in 98.2% of cases and revealed suboptimal stent implantation in 31.0% of lesions, with increased incidence in patients experiencing major adverse cardiac events (MACE) during follow-up (59.2% vs. 26.9%; p < 0.001). In particular, in-stent minimum lumen area <4.5 mm(2) (hazards ratio [HR]: 1.64; p = 0.040), dissection >200 μm at the distal stent edge (HR: 2.54; p = 0.004), and reference lumen area <4.5 mm(2) at either distal (HR: 4.65; p < 0.001) or proximal (HR: 5.73; p < 0.001) stent edges were independent predictors of MACE. Conversely, in-stent minimum lumen area/mean reference lumen area <70% (HR: 1.21; p = 0.45), stent malapposition >200 μm (HR: 1.15; p = 0.52), intrastent plaque/thrombus protrusion >500 μm (HR: 1.00; p = 0.99), and dissection >200 μm at the proximal stent edge (HR: 0.83; p = 0.65) were not associated with worse outcomes. Using multivariable Cox hazard analysis, the presence of at least 1 significant criterion for suboptimal OCT stent deployment was confirmed as an independent predictor of MACE (HR: 3.53; 95% confidence interval: 2.2 to 5.8; p < 0.001). CONCLUSIONS Suboptimal stent deployment defined according to specific quantitative OCT criteria was associated with an increased risk of MACE during follow-up.
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Affiliation(s)
- Francesco Prati
- San Giovanni Addolorata Hospital, Rome, Italy; Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy.
| | - Enrico Romagnoli
- Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy
| | | | | | - Laura Gatto
- San Giovanni Addolorata Hospital, Rome, Italy; Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy
| | | | | | - Valeria Marco
- Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy
| | | | | | - Giulia Paoletti
- Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy
| | - Carlo Trani
- Università Cattolica Del Sacro Cuore, Rome, Italy
| | | | - Luigi Tavazzi
- GVM Care and Research, E.S. Health Science Foundation, Cotignola, Italy
| | - Gary S Mintz
- Cardiovascular Research Foundation, New York, New York
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46
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Men J, Huang Y, Solanki J, Zeng X, Alex A, Jerwick J, Zhang Z, Tanzi RE, Li A, Zhou C. Optical Coherence Tomography for Brain Imaging and Developmental Biology. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS : A PUBLICATION OF THE IEEE LASERS AND ELECTRO-OPTICS SOCIETY 2016; 22:6803213. [PMID: 27721647 PMCID: PMC5049888 DOI: 10.1109/jstqe.2015.2513667] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Optical coherence tomography (OCT) is a promising research tool for brain imaging and developmental biology. Serving as a three-dimensional optical biopsy technique, OCT provides volumetric reconstruction of brain tissues and embryonic structures with micrometer resolution and video rate imaging speed. Functional OCT enables label-free monitoring of hemodynamic and metabolic changes in the brain in vitro and in vivo in animal models. Due to its non-invasiveness nature, OCT enables longitudinal imaging of developing specimens in vivo without potential damage from surgical operation, tissue fixation and processing, and staining with exogenous contrast agents. In this paper, various OCT applications in brain imaging and developmental biology are reviewed, with a particular focus on imaging heart development. In addition, we report findings on the effects of a circadian gene (Clock) and high-fat-diet on heart development in Drosophila melanogaster. These findings contribute to our understanding of the fundamental mechanisms connecting circadian genes and obesity to heart development and cardiac diseases.
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Affiliation(s)
- Jing Men
- Department of Electrical and Computer Engineering, Center for Photonics and Nanoelectronics, and Bioengineering Program, Lehigh University, Bethlehem, PA, USA, 18015
| | - Yongyang Huang
- Department of Electrical and Computer Engineering, Center for Photonics and Nanoelectronics, and Bioengineering Program, Lehigh University, Bethlehem, PA, USA, 18015
| | - Jitendra Solanki
- Department of Electrical and Computer Engineering, Center for Photonics and Nanoelectronics, and Bioengineering Program, Lehigh University, Bethlehem, PA, USA, 18015
| | - Xianxu Zeng
- Department of Electrical and Computer Engineering, Center for Photonics and Nanoelectronics, and Bioengineering Program, Lehigh University, Bethlehem, PA, USA, 18015
- Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China, 450000
| | - Aneesh Alex
- Department of Electrical and Computer Engineering, Center for Photonics and Nanoelectronics, and Bioengineering Program, Lehigh University, Bethlehem, PA, USA, 18015
| | - Jason Jerwick
- Department of Electrical and Computer Engineering, Center for Photonics and Nanoelectronics, and Bioengineering Program, Lehigh University, Bethlehem, PA, USA, 18015
| | - Zhan Zhang
- Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China, 450000
| | - Rudolph E. Tanzi
- Genetics and Aging Research Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA, 02129
| | - Airong Li
- Genetics and Aging Research Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA, 02129
| | - Chao Zhou
- Department of Electrical and Computer Engineering, Center for Photonics and Nanoelectronics, and Bioengineering Program, Lehigh University, Bethlehem, PA, USA, 18015
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47
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Abstract
Coronary atherosclerosis and the precipitation of acute myocardial infarction are highly complex processes, which makes accurate risk prediction challenging. Rapid developments in invasive and noninvasive imaging technologies now provide us with detailed, exquisite images of the coronary vasculature that allow direct investigation of a wide range of these processes. These modalities include sophisticated assessments of luminal stenoses and myocardial perfusion, complemented by novel measures of the atherosclerotic plaque burden, adverse plaque characteristics, and disease activity. Together, they can provide comprehensive, individualized assessments of coronary atherosclerosis as it occurs in patients. Not only can this information provide important pathological insights, but it can also potentially be used to guide personalized treatment decisions. In this Review, we describe the latest advances in both established and emerging imaging techniques, focusing on the strengths and weakness of each approach. Moreover, we discuss how these technological advances might be translated from attractive images into novel imaging strategies and definite improvements in clinical risk prediction and patient outcomes. This process will not be easy, and the many potential barriers and difficulties are also reviewed.
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48
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Wilson R, Aung H, Ju X, Paterson C, Sayer R, McIntyre A, Going J, Irvine R, Berry C. Optical coherence tomography: an experimental validation for vascular imaging of saphenous vein bypass grafts. Biomed Phys Eng Express 2016. [DOI: 10.1088/2057-1976/2/2/025002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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49
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Lipid volume fraction in atherosclerotic plaque phantoms classified under saline conditions by multispectral angioscopy at near-infrared wavelengths around 1200 nm. Lasers Med Sci 2016; 31:619-24. [PMID: 26861978 DOI: 10.1007/s10103-016-1879-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/14/2016] [Indexed: 10/22/2022]
Abstract
To identify high-risk atherosclerotic lesions, we require detailed information on the stability of atherosclerotic plaques. In this study, we quantitatively classified the lipid volume fractions in atherosclerotic plaque phantoms by a novel angioscope combined with near-infrared multispectral imaging. The multispectral angioscope was operated at peak absorption wavelengths of lipid in vulnerable plaques (1150, 1200, and 1300 nm) and at lower absorption wavelengths of water. The potential of the multispectral angioscope was demonstrated in atherosclerotic plaque phantoms containing 10-60 vol.% lipid and immersed in saline solution. The acquired multispectral data were processed by a spectral angle mapper algorithm, which enhanced the simulated plaque areas. Consequently, we classified the lipid volume fractions into five categories (0-5, 5-15, 15-30, 30-50, and 50-60 vol.%). Multispectral angioscopy at wavelengths around 1200 nm is a powerful tool for quantitatively evaluating the stability of atherosclerotic plaques based on the lipid volume fractions.
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50
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Kim J, Ahmad A, Li J, Marjanovic M, Chaney EJ, Suslick KS, Boppart SA. Intravascular magnetomotive optical coherence tomography of targeted early-stage atherosclerotic changes in ex vivo hyperlipidemic rabbit aortas. JOURNAL OF BIOPHOTONICS 2016; 9:109-16. [PMID: 25688525 PMCID: PMC4996077 DOI: 10.1002/jbio.201400128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/14/2014] [Accepted: 01/02/2015] [Indexed: 05/19/2023]
Abstract
We report the development of an intravascular magnetomotive optical coherence tomography (IV-MM-OCT) system used with targeted protein microspheres to detect early-stage atherosclerotic fatty streaks/plaques. Magnetic microspheres (MSs) were injected in vivo in rabbits, and after 30 minutes of in vivo circulation, excised ex vivo rabbit aorta samples specimens were then imaged ex vivo with our prototype IV-MM-OCT system. The alternating magnetic field gradient was provided by a unique pair of external custom-built electromagnetic coils that modulated the targeted magnetic MSs. The results showed a statistically significant MM-OCT signal from the aorta samples specimens injected with targeted MSs.
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Affiliation(s)
- Jongsik Kim
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
| | - Adeel Ahmad
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
| | - Joanne Li
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
| | - Marina Marjanovic
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
| | - Eric J. Chaney
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
| | - Kenneth S. Suslick
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
- Department of Chemistry, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
| | - Stephen A. Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
- Department of Internal Medicine, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, USA 61801
- Corresponding author: , Phone: +01 217 333 8598, Fax: +01 217 333 5833
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