A schematic for the mechanism of accelerating the assembly of intercalated discs (IDs) in cardiac myocytes regulated by gold nanoparticles (AuNPs) is presented. AuNPs with local nanoscale stiffness in the substrate activate β1-integrin signaling, which mediates the activation of integrin-linked kinase (ILK) and its downstream signal kinase by stimulating expression of the transcription factors GATA4 and MEF-2c.

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The purpose of this study was to assess the impact of StentBoost Subtract (SBS) imaging on patient radiation dose during percutaneous coronary intervention. Data were prospectively collected between February 2010 and November 2012 at a tertiary cardiac catheterization. All patients who had scheduled for coronary stent implantation performed by one expert interventional cardiologist with sufficient experience in SBS imaging and radiation protection, were included. The patients were divided into groups with or without SBS. A multiple linear regression analysis was used to determine the impact of SBS imaging on patient radiation dose. Of 712 patients screened, 414 patients were enrolled in the study (with SBS: n = 177, without SBS: n = 237). Although the DAP, fluoroscopy time and cine frames used in the group with SBS were significantly increased when compared with those used in the group without SBS (P < 0.05), multiple linear regression shows SBS imaging has no significant impact on patient radiation dose (P > 0.05). Multivariate predictors of patient radiation dose were the patients' BMI, B2/C lesions, number of stents placed and bifurcation stenting (P < 0.05). In selected patients, SBS imaging can be performed with comparable patient radiation dose, compared with plain fluoroscopic imaging. This may attribute to the operator's sufficient experience in SBS imaging and radiation protection.

SummaryPercutaneous coronary intervention (PCI) of ostial lesions is complex and is technically very demanding. Intravascular ultrasound (IVUS) is considered the gold standard method to guide PCI but has several limitations. Stent boost subtract (SBS) imaging is an enhancement of the radiologic edge of the stent by digital management of regular X-ray images. The purpose of this study was to determine the availability of stent enhancement with SBS during ostial PCI by comparison with IVUS.We investigated SBS and IVUS after stent implantation in 58 ostial lesions in 55 patients. SBS and IVUS were performed in all patients to obtain improved stent location and to detect optimal release and deployment. We defined the SBS and IVUS criteria for accuracy of stent location and adequate stent deployment. IVUS findings showed that stent location was generally good. The location was accurate in 48 (82.8%) and inadequate stent deployment was observed in 10 of 58 (17.2%). Eight SBS images showed inadequate stent expansion. SBS predicted inadequate findings of IVUS with 100% specificity and 80% sensitivity, while a significant positive correlation was observed between SBS-MSA and MSA by IVUS with a regression coefficient of 0.95.Imaging techniques have a primary role during ostial PCI. SBS is a simple and quick method that offers several advantages, enabling improved stent location, adequate stent expansion, and optimal apposition of the struts to the wall. SBS imaging could be conventionally used during ostial PCI, especially in centers where IVUS is not used routinely. (Int Heart J 2015; 56: 37-42) Key words: Percutaneous coronary intervention, Apposition, Stent location, Stent expansion P ercutaneous coronary intervention (PCI) of coronary ostial lesions is technically difficult leading to higher rates of adverse cardiac events compared with PCI of non-ostial coronary lesions.1-4) The challenges of PCI of an ostial lesion may depend not only upon the lesion location (ie, aorto-ostial versus non-aorto-ostial), but also on the plaque burden and lesion morphology. Ostial lesions are less compliant compared with non-ostial lesions due to increased fibrosis, calcification, and muscular/elastic tissue, the latter of which is especially evident in aorto-ostial disease.5) Complete stent coverage of ostial lesions can be problematic, with inaccurate stent placement leading to higher rates of restenosis. 6) Compared with coronary angiography, intravascular ultrasound (IVUS) allows for a more detailed assessment of coronary anatomy, including plaque characteristics and morphology, vessel size, and precise localization of the true ostium.7) The only reliable way to exclude insufficient stent deployment with certainty is IVUS.8-10) However, in daily practice, this technique is not used routinely because it is expensive, time-consuming, and there is a learning curve (requiring trained operators and laboratory staff).11) Moreover, it is difficult to obtain an accurate location of the stent before the stent is released. Stent boost sub...