In Vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography

Wang, Xiao; Matsumura, Mitsuaki; Mintz, Gary S.; Lee, Tetsumin; Zhang, Wenbin; Cao, Yang; Fujino, Akiko; Lin, Yongqing; Usui, Eisuke; Kanaji, Yoshihisa; Murai, Tadashi; Yonetsu, Taishi; Kakuta, Tsunekazu; Maehara, Akiko

doi:10.1016/j.jcmg.2017.05.014

Cited by 155 publications

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“…[ 20 21 ] In our study, lesions with a large angle of calcium that were thin (<0.5 mm in thickness) did not appear to inhibit stent expansion. [ 22 ]…”

Section: Discussionmentioning

confidence: 99%

Acute- and Long-term Outcomes of Rotational Atherectomy followed by Cutting Balloon versus Plain Balloon before Drug-Eluting Stent Implantation for Calcified Coronary Lesions

Wang

Suo

et al. 2018

Chinese Medical Journal

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Background:Coronary calcification is a major determinant of stent underexpansion and subsequent adverse events. This study aimed to evaluate the acute- and long-term outcomes of rotational atherectomy (RA) followed by cutting balloon (CB) versus plain balloon before drug-eluting stent implantation for calcified coronary lesions.Methods:From June April 2013 to March 2016, a total of 127 patients with moderately or severely calcified coronary lesions were treated with RA. Patients were divided into two groups according to the balloon type after RA: RA+CB group (n = 75) and RA+plain balloon group (n = 52). Minimal lumen diameter and acute lumen gain were analyzed by quantitative coronary angiography. In-hospital and long-term (>1 year) outcomes were recorded. Multivariate Cox regression analysis was performed to determine the independent predictors of in-stent restenosis.Results:The mean age of the patients was 65.5 years, and 76.4% were men. Total lesion length and minimal lumen diameter at baseline were similar in the two groups. After RA and balloon dilation, the lumen diameter was significantly larger in the RA+CB group than in the RA+plain balloon group (1.57 ± 0.46 mm vs. 1.10 ± 0.40 mm, t = 4.123, P < 0.001). The final lumen diameter was also larger in the RA+CB group compared to that in the RA group (2.81 ± 0.41 mm vs. 2.60 ± 0.25 mm, t = 2.111, P = 0.039). Moreover, patients receiving RA and CB tended to have larger final lumen gain (2.15 ± 0.48 mm vs. 1.95 ± 0.47 mm, t = 1.542, P = 0.132). Multivariate Cox regression analysis indicated that the strategy of RA+CB was a significant protective factor against long-term (>1 year) in-stent restenosis (hazard ratio: 0.136, 95% confidence interval: 0.020–0.936, P = 0.043).Conclusions:In patients with moderately or severely calcified lesions, a strategy of RA followed by CB before stent implantation can increase lumen diameter and acute lumen gain. This strategy is safe with lower risk of long-term in-stent restenosis.

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“…[ 20 21 ] In our study, lesions with a large angle of calcium that were thin (<0.5 mm in thickness) did not appear to inhibit stent expansion. [ 22 ]…”

Section: Discussionmentioning

confidence: 99%

Acute- and Long-term Outcomes of Rotational Atherectomy followed by Cutting Balloon versus Plain Balloon before Drug-Eluting Stent Implantation for Calcified Coronary Lesions

Wang

Suo

et al. 2018

Chinese Medical Journal

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“…Recently, OCT has emerged as the premier intracoronary imaging technology with a higher resolution (10–20 µm) than IVUS (100–200 µm) and also when compared with noninvasive CT and magnetic resonance imaging, both with a lower resolution (1 mm) 53 – 58 ) . It cannot detect a cell apotosis based microcalcification because of its size (< 10–20 µm).…”

Section: Plaque Calcification and Clinical Implicationsmentioning

confidence: 99%

Plaque Calcification During Atherosclerosis Progression and Regression

Shioi

Ikari

2018

J Atheroscler Thromb

203

149

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Plaque calcification develops by the inflammation-dependent mechanisms involved in progression and regression of atherosclerosis. Macrophages can undergo two distinct polarization states, that is, pro-inflammatory M1 phenotype in progression and anti-inflammatory M2 phenotype in regression. In plaque progression, predominant M1 macrophages promote the initial calcium deposition within the necrotic core of the lesions, called as microcalcification, through not only vesicle-mediated mineralization as the result of apoptosis of macrophages and vascular smooth muscle cells (VSMCs), but also VSMC differentiation into early phase osteoblasts. On the other hand, in plaque regression M2 macrophages are engaged in the healing response to plaque inflammation. In association with the resolution of chronic inflammation, M2 macrophages may facilitate macroscopic calcium deposition, called as macrocalcification, through induction of osteoblastic differentiation and maturation of VSMCs. Oncostatin M, which has been shown to promote osteoblast differentiation in bone, may play a pivotal role in the development of plaque calcification. Clinically, two types of plaque calcification have distinct implications. Macrocalcification leads to plaque stability, while microcalcification is more likely to be associated with plaque rupture. Statin therapy, which reduces cardiovascular mortality, has been shown to exert its dual actions on plaque morphology, that is, regression of atheroma and increment of macroscopic calcium deposits. Statins may facilitate the healing process against plaque inflammation by enhancing M2 polarization of macrophages. Vascular calcification has pleiotropic properties as pro-inflammatory “microcalcification” and anti-inflammatory “macrocalcification”. The molecular mechanisms of this process in relation with plaque progression as well as plaque regression should be intensively elucidated.

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“…Это метод внутрисосудистой светооптической визуализации, использующий лазерное излучение с длиной волны 1 300 нм для получения информации о трехмерном строении сосудистой стенки. В последнее время ОКТ стала ведущей технологией внутрикоронарной визуализации с более высоким разрешением (10-20 мкм), чем ВСУÇИ (100-200 мкм) [10,11].…”

Section: инвазивные методыunclassified

Assessment of calcification of the coronary arteries and long-term prognosis of cardiovascular disease

et al. 2020

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1 Научно-исследовательский институт терапии и профилактической медицины (НИИТПМ)филиал Федерального исследовательского центра «Институт цитологии и генетики» Сибирского отделения Российской академии наук (ФИЦ ИЦиГ СО РАН) Россия, 630089, г. Новосибирск, ул. Бориса Богаткова, 175/1 2 Новосибирский государственный технический университет (НГТУ) Россия, 630073, г. Новосибирск, пр. Карла Маркса, 20 РЕЗЮМЕ Сосудистая кальцификация является отличительной чертой сердечно-сосудистых заболеваний атеросклеросклеротического генеза. Визуализация кальцификатов осуществляется инвазивными и неинвазивными методами. Çнания о наличии и степени кальциноза могут предсказать клинические исходы у пациентов с высоким риском коронарных событий, помочь при проведении профилактики и лечении ишемической болезни сердца.В статье представлены краткая характеристика методов визуализации сосудистого кальция и обзор исследований по изучению связи кальцификации с риском отдаленных неблагоприятных сердечнососудистых событий.Ключевые слова: кальцификация, коронарный атеросклероз, методы оценки кальцификации, сердечно-сосудистые заболевания.Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи Источник финансирования. Работа выполнена в рамках и при финансовой поддержке гранта РФФИ № 19-015-00055, бюджетной темы по Государственному заданию № 0324-2018-0001.Для цитирования: Полонская Я.В., Каштанова Е.В., Аникина А.В., Рагино Ю.И. Оценка кальцификации коронарных артерий и отдаленный прогноз сердечно-сосудистых заболеваний. Бюллетенü сибирской медиöины. 2020; 19 (1): 172-179. https://doi. ABSTRACTVascular calcification is a distinctive feature of cardiovascular diseases of atherosclerotic origin. Visualization of calcifications is carried out by invasive and non-invasive methods. Knowledge of the presence and degree of calcification can predict clinical outcomes in patients at high risk of coronary events, help in the prevention and treatment of coronary heart disease.The article presents a brief description of the methods of visualization of vascular calcium and a review of studies on the relationship of calcification with the risk of long-term adverse cardiovascular events.

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In Vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography

Abstract: Angiographic detection of target lesion coronary calcium (compared to intravascular imaging) has not changed in the past 2 decades, and angiographically invisible calcium (only detectable by IVUS or OCT) did not appear to inhibit stent expansion.

Cited by 155 publications

References 20 publications

Acute- and Long-term Outcomes of Rotational Atherectomy followed by Cutting Balloon versus Plain Balloon before Drug-Eluting Stent Implantation for Calcified Coronary Lesions

Acute- and Long-term Outcomes of Rotational Atherectomy followed by Cutting Balloon versus Plain Balloon before Drug-Eluting Stent Implantation for Calcified Coronary Lesions

Plaque Calcification During Atherosclerosis Progression and Regression

Assessment of calcification of the coronary arteries and long-term prognosis of cardiovascular disease

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