Quantification of strain analysis and late gadolinium enhancement in coronary chronic total occlusion: a cardiovascular magnetic resonance imaging follow-up study

Zhang, Lijun; Tian, Jinfan; Yang, Xiumin; Liu, Jielin; He, Yi; Song, Xiaoyan

doi:10.21037/qims-21-702

Cited by 3 publications

(1 citation statement)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recanalization of coronary chronic total occlusion (CTO) is associated with better clinical outcomes and improved quality of life (1)(2)(3)(4). However, percutaneous coronary intervention (PCI) for CTO is challenging for cardiologists, given its complex procedures, low success rates, and high suboptimal and complication rates (5,6).…”

Section: Introductionmentioning

confidence: 99%

Quantitative coronary computed tomography angiography assessment of chronic total occlusion percutaneous coronary intervention

Xing¹,

Zhang²,

Zhang³

et al. 2022

Quant Imaging Med Surg

Self Cite

View full text Add to dashboard Cite

Background: Morphological and clinical characteristics are widely used to predict the success of percutaneous coronary intervention (PCI) in patients with chronic total occlusion (CTO). However, the impact of quantitative characteristics derived from coronary computed tomography angiography (CCTA) on guidewire crossing and PCI success is still unclear. This study aimed to explore the association between these quantitative characteristics and the difficulty of PCI for CTO.Methods: A total of 207 CTO lesions from 201 patients (84.6% male; mean age 58.9 years) with preprocedural CCTA scans who had undergone PCI for CTO were retrospectively enrolled in this casecontrol study. A semi-automated CCTA plaque-analysis software was adopted to obtain the total plaque volume and volume of each component according to the Hounsfield Unit (HU) value, including dense calcium (>351 HU), fibrous (131-350 HU), fibrofatty (76-130 HU), and necrotic core (−30-75 HU) tissue. Differences in the quantitative characteristics of the CTO lesions were compared between: (I) the group of lesions with successful guidewire crossing (≤30 min) and the group with failed guidewire crossing (≤30 min); (II) the group of lesions with procedural success [defined as achieving residual stenosis of <30% and a grade 3 thrombolysis in myocardial infarction (TIMI) flow] and the group with procedural failure.Logistic regression was used to explore the association of quantitative characteristics with successful guidewire crossing in ≤30 min and procedural success.Results: A total of 131 (63.3%) lesions of 126 patients achieved successful guidewire crossing in ≤30 min and 157 (75.8%) lesions of 152 (75.6%) patients achieved procedural success. Quantitative characteristics such as occlusion length, plaque volume, volume of dense calcium, and fibrous and fibrofatty tissue showed significant differences between the groups of lesions with successful guidewire crossing in ≤30 min and with failed guidewire crossing in ≤30 min, as well as the groups of lesions with procedural success and with procedural failure. According to the results of logistic regression analysis, lower percentages of dense calcium [odds ratio (OR) =0.970, 95% confidence interval (CI): 0.950 to 0.991; P=0.004] and fibrous (OR =0.970, 95% CI: 0.949 to 0.992; P=0.007) tissue and higher percentage of necrotic core tissue (OR =1.018, 95% CI: 1.005 to 1.030; P=0.005) were significantly associated with successful guidewire crossing in ≤30 min. Decreased percentages of dense calcium (OR =0.969; 95% CI: 0.949 to 0.989; P=0.002) and fibrous tissue (OR =0.966, 95% CI: 0.944 to 0.990; P=0.005) and higher percentage of necrotic core tissue (OR =1.022, 95% CI: 1.008 to 1.036; P=0.002) were associated with procedural success. After adjusting for cardiovascular risk factors, the percentages of dense calcium, fibrous, and necrotic core tissue were still associated with successful guidewire crossing in ≤30 min, and the quantitative parameters showed consistent association with procedural success.Conclusions: Quant...

show abstract

Section: Introductionmentioning

confidence: 99%

Quantitative coronary computed tomography angiography assessment of chronic total occlusion percutaneous coronary intervention

Xing¹,

Zhang²,

Zhang³

et al. 2022

Quant Imaging Med Surg

Self Cite

View full text Add to dashboard Cite

show abstract

Baseline angina burden predicts quality of life and functional improvement in patients with viable myocardium treated for chronic total occlusion

Kersten,

Maisenbacher,

Fengel

et al. 2023

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Chronic total occlusion (CTO) is a common finding in patients with known or suspected coronary artery disease and has a distinctive role in these patients’ quality of life. However, there is still a lack of evidence of correct patient selection for percutaneous coronary intervention (PCI). From July 2017 to August 2020, 68 patients with successful PCI of a CTO and previous evidence of viability for PCI by cardiovascular magnetic resonance imaging (CMR) were prospectively included in this single-centre observational study. Of these patients, 62 underwent follow-up CMR, and 56 underwent surveys using the Seattle Angina Questionnaire before PCI and 3, 12 and 24 months after PCI. The CMR results were assessed for volumetric, functional and deformation parameters. From the baseline to the follow-up, there was a significant reduction in the left ventricular volumes (all p < 0.001) and an increase in the left ventricular ejection fraction (57.6 ± 11.6% vs. 60.3 ± 9.4%, p = 0.006). Among the deformation parameters, only the left ventricular radial strain showed significant improvement. The SAQ showed an early improvement that emphasised angina stability and frequency as well as a summary score, which persisted after 24 months. A low SAQ summary score before PCI was the best predictive factor of good clinical improvement thereafter. Improvements in myocardial function and quality of life can be achieved with PCI of a CTO. Patient selection for PCI should be performed primarily among relevantly symptomatic patients when evidence of viability for PCI is present. The SAQ can help guide such patient selection.Trial registration ISRCTN, identifier: ISRCTN33203221. Retrospectively registered on 01.04.2020. https://www.isrctn.com/ISRCTN33203221

show abstract

Myocardial Strain Measurements Derived From MR Feature-Tracking

Yang

Zhu

et al. 2024

JACC: Cardiovascular Imaging

View full text Add to dashboard Cite

Quantification of strain analysis and late gadolinium enhancement in coronary chronic total occlusion: a cardiovascular magnetic resonance imaging follow-up study

Cited by 3 publications

References 33 publications

Quantitative coronary computed tomography angiography assessment of chronic total occlusion percutaneous coronary intervention

Quantitative coronary computed tomography angiography assessment of chronic total occlusion percutaneous coronary intervention

Baseline angina burden predicts quality of life and functional improvement in patients with viable myocardium treated for chronic total occlusion

Myocardial Strain Measurements Derived From MR Feature-Tracking

Contact Info

Product

Resources

About