Relationship between optical coherence tomography-derived morphological criteria and functional relevance as determined by fractional flow reserve

Usui, Eisuke; Yonetsu, Taishi; Kanaji, Yoshihisa; Hoshino, Masahiro; Yoshizumi, Masao; Hada, Masahiro; Fukuda, Taeko; Ohya, Hiroaki; Sumino, Yohei; Hamaya, Rikuta; Kanno, Yoshinori; Murai, Tadashi; Lee, Tetsumin; Kakuta, Tsunekazu

doi:10.1016/j.jjcc.2017.09.010

Cited by 7 publications

(5 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 77%

“…Although morphological characteristics of plaques, such as lipid arc and lipid length assessed by OCT presented a significant correlation with FFR in studies by Usui et al and Lee et al [21,27], no independent association with FFR in the model including OCT-derived MLA could be demonstrated. The present study also builds up on the recently published results from a smaller study by Burzotta et al who, amongst 45 patients with CAD, found that a combination of different OCT parameters, such as MLA, % area stenosis, presence of thrombus or plaque ulceration could aid in prediction of significant FFR results [4].…”

mentioning

confidence: 77%

See 1 more Smart Citation

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

Tomaniak

Ochijewicz

Kołtowski

et al. 2021

JCM

View full text Add to dashboard Cite

Background: optical coherence tomography (OCT) might allow identifying lesion features reportedly associated with plaque vulnerability and increased risk of clinical events. Previous studies on correlation between OCT and functional lesion significance indices reported contradictory results, yet integration of complementary information from both modalities is gaining increased interest. The aim of the study was to compare plaque morphology using OCT in hemodynamically relevant vs. non-relevant lesions by fractional flow reserve (FFR). Methods: consecutive patients with intermediate grade coronary stenoses by angiography were evaluated by both FFR and OCT in this single-center study. Stenoses were labeled hemodynamically relevant in case of the FFR ≤ 0.80. Minimal lumen area (MLA), fibrous cap thickness (FCT), minimal cap thickness over the calcium, angle of the calcium, and necrotic core within the lesions were evaluated. Results: a total of 105 patients (124 vessels) were analyzed. Of them, 65 patients were identified with at least one lesion identified as hemodynamically relevant by FFR (72 vessels, 58.1%). Lesions with FFR ≤0.80 presented with lower mean and minimal lumen area (3.46 ± 1.29 vs. 4.65 ± 2.19, p =0.001 and 1.84 ± 0.97 vs. 2.66 ± 1.40, p = 0.001) compared to patients with FFR > 0.80. No differences were found between groups in the mean and minimal FCT, mean, and maximal necrotic core, calcium angle, as well as the overall rate of calcified and lipid plaques. Conclusion: hemodynamic relevance of intermediate grade lesions correlated moderately with the luminal assessment by OCT. No differences were identified in the plaque morphology between relevant and non-relevant coronary stenoses by FFR.

show abstract

Section: Discussionmentioning

confidence: 77%

mentioning

confidence: 77%

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

Tomaniak

Ochijewicz

Kołtowski

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…There is a wide range of OCT parameters values which can have a strong correlation with hemodynamic significance of a coronary lesion, but this values depend on the cut-off chosen for the differentiation of ischemic and non-ischemic lesions [11,15,17]. While for a cut-off value of 0,75 a much lower threshold for MLA was obtained in other studies [11], for the present analysis the FFR cut-off was chosen to be 0,80 for the purpose of being in line with the majority of studies addressing the same parameters. According to our results, a MLA derived from OCT has a good correlation with a FFR value under 0,80.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have investigated the correlation between minimal luminal area (MLA) measured by OCT and FFR in patients with coronary artery disease for patients with chronic coronary syndromes [10][11][12] . The aim of the studies was to establish a relationship between the anatomical and physiological assessments of coronary lesions in patients with acute myocardial infarction.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Value of Optical Coherence Tomography Parameters in Estimating Non-critical Lesions in Patients with Acute Myocardial Infarction

Ploscaru,

Câlmâc,

Bajdechi

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Coronary artery disease (CAD) remains a significant global health concern, being one of the most important contributors to morbidity and mortality worldwide. Accurate assessment of coronary lesions is crucial for guiding appropriate interventions and optimizing patient outcomes. Patients with acute myocardial infarction represent a population which is rarely selected in studies of intracoronary hemodynamics. Fractional Flow Reserve (FFR) has emerged as a valuable physiological index for evaluating the functional significance of coronary lesions, although the data of intravascular hemodynamic evaluation in patients with acute myocardial infarction is scarce [1-3]. In recent years, advancements in intravascular imaging techniques, such as Optical Coherence Tomography (OCT), have provided detailed insights into coronary anatomy both in acute or elective settings. [4-7]. Methods: This article aims to explore the correlation between different non-culprit vessel OCT-parameters and FFR value in the patients with recent acute myocardial infarction. The study included 114 patients with acute myocardial infarction (ST elevation myocardial infarction and non ST elevation myocardial infarction)for whom primary PCI (percutaneous coronary intervention) was performed for the culprit lesion. The non-culprit vessels with intermediate coronary stenoses (157 lesions) were evaluated in a staged procedure (during the index hospitalization) with OCT, FFR and revascularization was performed accordingly. Minimal luminal area (MLA) and percent luminal area stenosis (PSA) were analyzed in relation with the FFR value. Results: There is good correlation between OCT-derived parameters and FFR values in patients with recent acute myocardial infarction. Minimal luminal area (MLA) and percent luminal stenosis area (PSA) were independent predictors of FFR< 0,80 in multivariate logistic regression analysis. A value of 2,08 mm2 for the MLA and 76,85 % for the PSA have proved to be the best cut-offs for predicting a FFR< 0,80. Conclusions: OCT parameters are valuable additional tools in current angiographic practice, including patients with acute myocardial infarction, with the ability to bring numerous direct imagistic and indirect hemodynamic information.

show abstract

“…OCT examination was performed using frequency-domain OCT systems: Abbott’s OCT (Ilumien Optis, Abbott Vascular, Santa Clara, CA, USA) or Terumo’s optical frequency-domain imaging system (Lunawave, Terumo Corporation, Tokyo, Japan), as previously described [ 12 , 13 ]. OCT pullback was performed automatically by the dedicated device during the injection of flushing agents, either contrast medium or low-molecular-weight dextran with Ringer’s lactate solution, at a flow rate of 3–4 mL/s via the guiding catheter using an automated power injector pump.…”

Section: Methodsmentioning

confidence: 99%

Relationship of OCT-defined plaque characteristics with CCTA-derived coronary inflammation and CMR-derived global coronary flow reserve in patients with acute coronary syndrome

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background The relationship of layered plaque detected by optical coherence tomography (OCT) with coronary inflammation and coronary flow reserve (CFR) remains elusive. We aimed to investigate the association of OCT-defined layered plaque with pericoronary adipose tissue (PCAT) inflammation assessed by coronary computed tomography angiography (CCTA) and global (G)-CFR assessed by cardiac magnetic resonance imaging (CMR) in patients with acute coronary syndrome (ACS). Methods We retrospectively investigated 88 patients with first ACS who underwent preprocedural CCTA, OCT imaging of the culprit lesion prior to primary/urgent percutaneous coronary intervention (PCI), and postprocedural CMR. All patients were divided into two groups according to the presence and absence of OCT-defined layered plaque at the culprit lesion. Coronary inflammation was assessed by the mean value of PCAT attenuation (−190 to −30 HU) of the three major coronary vessels. G-CFR was obtained by quantifying absolute coronary sinus flow at rest and during maximum hyperemia. CCTA and CMR findings were compared between the groups. Results In a total of 88 patients, layered plaque was detected in 51 patients (58.0%). The patients with layered plaque had higher three-vessel-PCAT attenuation value (-68.58 ± 6.41 vs. -71.60 ± 5.21 HU, P = 0.021) and culprit vessel-PCAT attenuation value (-67.69 ± 7.76 vs. -72.07 ± 6.57 HU, P = 0.007) than those with non-layered plaque. The patients with layered plaque had lower G-CFR value (median, 2.26 [interquartile range, 1.78, 2.89] vs. 3.06 [2.41, 3.90], P = 0.003) than those with non-layered plaque. Conclusions The presence of OCT-defined layered plaque at the culprit lesion was associated with high PCAT attenuation and low G-CFR after primary/urgent PCI in patients with ACS. OCT assessment of culprit plaque morphology and detection of layered plaque may help identify increased pericoronary inflammation and impaired CFR, potentially providing the risk stratification in patients with ACS and residual microvascular dysfunction after PCI.

show abstract

Relationship between optical coherence tomography-derived morphological criteria and functional relevance as determined by fractional flow reserve

Abstract: Information on OCT-derived LVI and lesion locations facilitates better identification of coronary lesions that cause ischemia than OCT-derived MLA analysis alone.

Cited by 7 publications

References 36 publications

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

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

Exploring the Value of Optical Coherence Tomography Parameters in Estimating Non-critical Lesions in Patients with Acute Myocardial Infarction

Relationship of OCT-defined plaque characteristics with CCTA-derived coronary inflammation and CMR-derived global coronary flow reserve in patients with acute coronary syndrome

Contact Info

Product

Resources

About