OCT-Derived Plaque Morphology and FFR-Determined Hemodynamic Relevance in Intermediate Coronary Stenoses

Tomaniak, Mariusz; Ochijewicz, Dorota; Kołtowski, Łukasz; Rdzanek, Adam; Pietrasik, Arkadiusz; Jąkała, Jacek; Ślęzak, M.; Malinowski, Krzysztof Piotr; Zaleska, Martyna; Maksym, Jakub; Baruś, Piotr; Roleder, Tomasz; Filipiak‬, Krzysztof J.; Opolski, Grzegorz; Kochman, Janusz

doi:10.3390/jcm10112379

Cited by 12 publications

(12 citation statements)

References 38 publications

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“…The OCT threshold, which best correlated to hemodynamically significant FFR values, was MLA <2.05 mm 2 , addressing the possibility of using OCT along with FFR to assess hemodynamically significant lesions. Similar results regarding OCT-derived MLA were reported by Tomaniak et al [104]. Although, they reported a moderate correlation of OCT-derived MLA and lesion length with FFR values, there was no difference in terms of plaque morphological characteristics between the hemodynamically significant and hemodynamically non-significant lesions, as assessed by FFR.…”

Section: Intracoronary Imaging and Ffr Assessmentsupporting

confidence: 88%

Intracoronary Imaging: Current Practice and Future Perspectives

Tsigkas¹,

Spyropoulou²,

Bousoula³

et al. 2023

Rev. Cardiovasc. Med.

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Intracoronary imaging has brought new insight in the field of interventional cardiology. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are the most commonly used imaging modalities. Regarding their technical characteristics IVUS and OCT have similarities as well as differences, a fact that could have significant clinical implications. Both techniques play an important role in percutaneous coronary intervention (PCI) guidance and demonstrated superiority compared to intravascular coronary angiography (ICA) guidance alone. Furthermore, their use can notably assist coronary plaque evaluation; both provide additional information of plaque characteristics, which can lead to a better understanding of the cause of an acute coronary syndrome (ACS) and better clinical outcomes. However, there is not enough clinical evidence for the superiority of one method compared to the other, something that is, also, reflected in the guidelines. In this review, we aim to compare role of IVUS and OCT in the different aspects of coronary artery disease (CAD), according to the latest scientific data. In addition, we present the future perspectives regarding the IVUS and OCT, with co-registration of the two methods or hybrid OCT-IVUS catheters.

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Section: Intracoronary Imaging and Ffr Assessmentsupporting

confidence: 88%

Intracoronary Imaging: Current Practice and Future Perspectives

Tsigkas¹,

Spyropoulou²,

Bousoula³

et al. 2023

Rev. Cardiovasc. Med.

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“…In the follow-up analysis, mild-to-moderate renal dysfunction was associated with increased all-cause mortality and a higher incidence of MACE during the 5-year observation. CKD is a well-established comorbidity that worsens prognosis [ 1 , 4 – 7 , 24 , 40 , 54 , 74 ].…”

Section: Discussionmentioning

confidence: 99%

“…This was a single-center, prospective, observational, longitudinal cohort study, which consecutively enrolled 100 patients (118 lesions) with CCS undergoing a coronary angiogram (CAG) in a tertiary heart center ( ClinicalTrials.gov registration nr: NCT06261866) [ 54 , 55 ]. Intermediate-grade coronary lesions were analyzed by a multimodality approach using OCT and FFR, and with IVUS in a subset of patients.…”

Section: Methodsmentioning

confidence: 99%

A 5-Year Follow-Up Study of 100 Patients with 118 Intermediate Coronary Artery Lesions Evaluated by Fractional Flow Reserve and Intravascular Imaging Stratified According to Renal Function

Baruś,

Hunia,

Kaczorowski

et al. 2024

Med Sci Monit

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Background Progression of chronic coronary syndrome (CCS) is influenced by chronic kidney disease (CKD). This 5-year follow-up study aimed to assess 100 patients with 118 intermediate coronary artery lesions evaluated by fractional flow reserve (FFR) and intravascular imaging stratified according to renal function. Material/Methods This prospective study enrolled patients with intermediate coronary stenosis identified by coronary angiogram. Patients with severe renal dysfunction (estimated glomerular filtration rate (eGFR) <45 ml/min/1.73 m 2 ) were excluded from the study. The remaining were divided into 2 groups according to eGFR: 45–60 ml/min/1.73 m 2 for mild-to-moderate renal dysfunction and >60 ml/min/1.73 m 2 for no renal dysfunction. We analyzed intermediate-grade stenoses (40–80% as assessed in coronary angiography) with the use of optical coherence tomography (OCT), FFR, and intravascular ultrasound (IVUS). Results Renal dysfunction patients were older (67.7±8.1 vs 63.6±9.7 years, P =0.044). Lesion characteristics, including plaque type and minimal lumen area in OCT, showed no significant differences between the renal dysfunction and no renal dysfunction groups. Thin-cap fibroatheroma, calcific plaques, lipidic plaques, and fibrous plaques had similar prevalence. FFR values and IVUS parameters did not significantly differ between the groups. Over a 5-year follow-up, individuals with mild-to-moderate renal dysfunction had an elevated risk of all-cause mortality and major adverse cardiovascular events in multivariate analyses adjusted for age and sex. Conclusions Mild-to-moderate renal dysfunction was not associated with significant differences in OCT- and IVUS-derived plaque morphology nor with functional indices characterizing intermediate-grade coronary stenoses. Renal dysfunction was related to a higher risk of all-cause mortality and major adverse cardiovascular events prevalence in 5-year follow-up.

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“…In this work, we firstly performed FEM simulations to better understand the influence of various relevant parameters on the piezoelectric response of Si/SL/NWs/PMMA composite. The main objective of this task involved achieving an optimal design structure, which relied on the material properties and geometries so as to meet a high sensing performance that could be adapted to biological media in future applications [55][56][57]. The simulation results revealed that the mechanical Young's modulus, as well as the dielectric permittivity of the PMMA bottom matrix, had a high impact on the output voltage, contrary to those of the top layer, where no worthy effect has been observed.…”

Section: Discussionmentioning

confidence: 99%

Characterizing and Optimizing Piezoelectric Response of ZnO Nanowire/PMMA Composite-Based Sensor

et al. 2021

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Due to the outstanding coupling between piezoelectric and semiconducting properties of zinc oxide nanowires, ZnO NW-based structures have been demonstrating promising potential with respect to their applicability in piezoelectric, piezotronic and piezo-phototronic devices. Particularly considering their biocompatibility and biosafety for applications regarding implantable medical detection, this paper proposed a new concept of piezoelectric composite, i.e., one consisting of vertically aligned ZnO NW arrays and an insulating polymer matrix. First, the finite element method (FEM) was employed to drive optimization strategies through adjustment of the key parameters such as Young’s modules and the dielectric constant of the dielectric constituents, together with the density and dimension of nanowire (NW) itself. Second, to investigate the functionality of each individual layer of composite, different designed structures were fabricated and characterized in terms of electrical and piezoelectric properties. Next, experimental and simulation tests were performed, indicating that the decreasing thickness of the top poly(methyl methacrylate) layer (PMMA) can substantially enhance the piezoelectric sensitivity of the ZnO NW composite. Besides the further benefit of no polarization being needed, our material has a comparable charge coefficient (d33) with respect to other lead-free alternatives (e.g., BaTiO3), confirming the high sensing abilities of the developed structure based on vertically aligned ZnO NW arrays. Finally, a time-varying model combining piezoelectricity and electric circuit modules was investigated in detail, giving rise to an estimation of the d33 coefficient for ZnO NWs. Based on this study, the developed material is revealed to be highly promising in medical applications, particularly regarding the FFR technique, where coronary pressure can be measured through a piezoelectric sensor.

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OCT-Derived Plaque Morphology and FFR-Determined Hemodynamic Relevance in Intermediate Coronary Stenoses

Cited by 12 publications

References 38 publications

Intracoronary Imaging: Current Practice and Future Perspectives

Intracoronary Imaging: Current Practice and Future Perspectives

A 5-Year Follow-Up Study of 100 Patients with 118 Intermediate Coronary Artery Lesions Evaluated by Fractional Flow Reserve and Intravascular Imaging Stratified According to Renal Function

Characterizing and Optimizing Piezoelectric Response of ZnO Nanowire/PMMA Composite-Based Sensor

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