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Kosugi S, Ueda Y, Abe H, Mishima T, Shinouchi K, Ozaki T, Takayasu K, Iida Y, Ohashi T, Toriyama C, Nakamura M, Date M, Uematsu M, Koretsune Y. Angioscopic evaluation of vascular healing at 1 and 12 months after drug-coated stent implantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Polymer- and carrier-free Biolimus-A9-coated stent (DCS) is expected better vascular healing compared with conventional durable polymer drug-eluting stents (DES). Moreover, DCS had been demonstrated in clinical trials to allow one-month short dual antiplatelet therapy, which might achieve sufficient healing at only 1 month after implantation. However, the process of vascular healing after DCS implantation has not been elucidated by angioscopic observation.
Purpose
To evaluate the process of vascular healing at 1 month and 12 months after DCS implantation.
Methods
This study included 57 patients treated with DCS or durable polymer everolimus-eluting stents (EES) in our hospital from April 2017 to April 2019. Firstly, the angioscopic findings of DCS at 1 month (n=16) and 12 months (n=14) after implantation were respectively compared with EES at 12 months after implantation (EES-12, n=35) as a standard healing status of DES. Secondary, angioscopic findings of DCS at 1 month and 12 months after implantation were compared among the serially observed eight patients. Neointimal coverage (NIC) grade, yellow colour grade, and the presence of thrombus were evaluated. NIC grade was classified as grade 0 (no neointimal coverage), grade 1 (struts were bulged into lumen but covered), grade 2 (struts were embedded in the neointima but visible), or grade 3 (struts were fully embedded and invisible). Yellow colour grade was classified as grade 0 (white), grade 1 (light yellow), grade 2 (yellow), or grade 3 (intensive yellow).
Results
At 1 month after DCS implantation, dominant NIC grade was lower (0.3±0.5 vs. 1.5±0.7, p<0.001) and the frequency of thrombus was higher (38% vs. 6%, p=0.008) than EES-12. On the other hands, at 12 months after DCS implantation, dominant NIC grade was higher (2.1±0.6 vs. 1.5±0.7, p=0.013) and the frequency of thrombus was not different (7% vs. 6%, p=1.000) in comparison with EES-12. By serial observation of DCS, dominant NIC grade was higher at 12 months than at 1 month (2.3±0.5 vs. 0.4±0.5, p<0.001), while yellow colour grade (1.0±0.5 vs. 1.5±1.2, p=0.227) and the frequency of thrombus adhesion (0% vs. 38%, p=0.200) were not different.
Conclusion
Compared with EES-12, vascular healing of DCS was inferior at 1 month but superior at 12 months.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Kosugi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Ueda
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - H Abe
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Mishima
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - K Shinouchi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Ozaki
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - K Takayasu
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Iida
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Ohashi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - C Toriyama
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Nakamura
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Date
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Uematsu
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Koretsune
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
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Toriyama C, Abe H, Nishida H, Nakamura M, Ohashi T, Iida Y, Kosugi S, Ozaki T, Shinouchi K, Mishima T, Date M, Ueda Y, Uematsu M, Koretsune Y. P92 A novel method of correcting the left ventricular stroke volume by Doppler echocardiography: comparison with multidetector computed tomography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although transthoracic Doppler echocardiography is widely used for estimating left ventricular stroke volume (SV), accelerated blood flow in the left ventricular (LV) outflow tract may lead to overestimation. SV can be calculated accurately from left ventricular end-systolic and end-diastolic volume determined by multi-detector computed tomography (MDCT). However, radiation exposure as well as the use of contrast medium hampers its routine use.
Purpose
The purpose of this study was to examine whether the correction of SV measured by pulsed wave Doppler echocardiography (SVdop) can accurately predicts SV obtained by MDCT (SVct).
Methods: We enrolled consecutive 61 patients who underwent both MDCT and transthoracic echocardiography. Patients with moderate or severe valvular diseases and valve replacement surgery were excluded. Correction of SV was explored with SVct as a reference.
Results: Univariate analysis showed that SVdop (r = 0.42, P = 0.0007) and patient age (r=-0.50, P < 0.0001) were significantly correlated with SVct. On the other hand, left ventricular ejection fraction calculated by Teicholz method (EFteich) (r = 0.19, P = 0.14), systolic blood pressure (r = 0.07, P = NS), and LV mass index (r=-0.02, P = NS) were not correlated with SVct. Multivariate analysis showed that SVdop, patient age and EFteich were the independent predictive factors for SVct (R2 = 0.49, P < 0.0001). Based on these correlations, we postulated SV as: corrected SV = SVdop × 0.40 + EFteich × 0.46 – age × 0.67 + 44.77. As expected, the correlation between corrected SV and SVct significantly improved (r = 0.70, P < 0.0001). Bland-Altman plot analysis showed that corrected SV significantly reduced the variation between SVdop and SVct, and diminished the overestimation of SVdop (Figure).
Conclusion: The new correction formula of SVdop may correct the overestimation of SV obtained by pulsed wave Doppler echocardiography, although the formula remains to be validated in a separate cohort of patients.
Abstract P92 Figure
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Affiliation(s)
| | - H Abe
- Osaka National Hospital, Osaka, Japan
| | - H Nishida
- Osaka National Hospital, Osaka, Japan
| | | | - T Ohashi
- Osaka National Hospital, Osaka, Japan
| | - Y Iida
- Osaka National Hospital, Osaka, Japan
| | - S Kosugi
- Osaka National Hospital, Osaka, Japan
| | - T Ozaki
- Osaka National Hospital, Osaka, Japan
| | | | - T Mishima
- Osaka National Hospital, Osaka, Japan
| | - M Date
- Osaka National Hospital, Osaka, Japan
| | - Y Ueda
- Osaka National Hospital, Osaka, Japan
| | - M Uematsu
- Osaka National Hospital, Osaka, Japan
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Yasumura K, Abe H, Iida Y, Kato T, Nakamura M, Toriyama C, Nishida H, Idemoto A, Shinouchi K, Mishima T, Awata M, Date M, Ueda Y, Uematsu M, Koretsune Y. P5682A new prognostic indicator in patients with acute decompensated heart failure including both ambulatory and nutritional statuses. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- K Yasumura
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - H Abe
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Iida
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Kato
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Nakamura
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - C Toriyama
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - H Nishida
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - A Idemoto
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - K Shinouchi
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Mishima
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Awata
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Date
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Ueda
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Uematsu
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Koretsune
- Osaka National Hospital, Cardiovascular Division, Osaka, Japan
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Shinouchi K, Iida Y, Toriyama C, Nishida H, Yasumura K, Yorifuji H, Kato T, Idemoto A, Mishima T, Yokoi K, Abe H, Date M, Ueda Y, Uematsu M, Koretsune Y. P2737Impact of preexisting chronic total occlusions of the coronary artery on the outcome of out-of-hospital sudden cardiac arrest patients with acute coronary syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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