Small lipid core burden index in patients with stable angina pectoris is also associated with microvascular dysfunction: Insights from intracoronary electrocardiogram

Sato, Takao; Yuasa, Sho; Ohta, Yusuke; Goto, Sonoka; Aizawa, Yoshifusa

doi:10.1007/s11239-021-02380-z

Cited by 5 publications

(7 citation statements)

References 29 publications

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“…10 For instance, in Sato's study, the prolongation of ST-segment elevation time recorded by IC-ECG was associated with higher max-lipid core burden index 4 mm detected by near-infrared spectroscopy with IVUS in stable angina patients, which might indicate distal embolisation and microvascular disease. 32 The results from this meta-analysis indicated that ST-segment elevation recorded by IC-ECG after PCI procedure was significantly associated with worse MACE outcomes and higher risk of myocardial infarction in angina or NSTEMI patients, but not significantly associated with cardiac death nor revascularisation. Although there were trends that the risks of cardiac death and revascularisation were higher when ST-segment elevation was observed, more cases might be needed to prove this hypothesis.…”

Section: Discussionmentioning

confidence: 78%

“…For instance, we could use vasodilators, loading dose of statin or embolic protection devices to reduce distal embolisation. 32 And, Vassilev's studies found that IC-ECG had good correlation with FFR, which might be used in guiding bifurcation PCI procedures. 5 16 According to our meta-analysis, EF was significantly higher during follow-up when ST-segment resolution Open access was observed on IC-ECG in STEMI patients.…”

Section: Discussionmentioning

confidence: 99%

“… 10 For instance, in Sato’s study, the prolongation of ST-segment elevation time recorded by IC-ECG was associated with higher max-lipid core burden index 4 mm detected by near-infrared spectroscopy with IVUS in stable angina patients, which might indicate distal embolisation and microvascular disease. 32 …”

Section: Discussionmentioning

confidence: 99%

“…Therefore, IC-ECG might provide useful information for guiding stent expansion 10. Moreover, Ikenaga and Sato found more plaque rupture, vulnerable plaque or higher lipid core burden when ST-segment elevation was observed, even persisted on IC-ECG 10 32. IC-ECG could help to distinguish the plaque, optimising medical therapies or PCI strategies.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic and diagnostic accuracy of intracoronary electrocardiogram recorded during percutaneous coronary intervention: a meta-analysis

Fan

et al. 2022

BMJ Open

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ObjectiveIntracoronary ECG (IC-ECG) recording has been shown to be sensitive and reliable for detecting myocardial viability and local myocardial ischaemia in some studies. But IC-ECG is neither widely used during percutaneous coronary intervention (PCI) nor recommended in guidelines. This up-to-date meta-analysis of published studies was conducted to evaluate the prognostic and diagnostic accuracy of IC-ECG recorded during PCI.MethodsRelevant studies were identified by searches of MEDLINE until 19 June 2021. Observational and diagnostic studies which reported the prognostic or diagnostic accuracy of IC-ECG were included. Data were extracted independently by two authors. Summary estimates of clinical outcomes were obtained using a random effects model. Summary diagnostic accuracy was obtained by using a Bayesian bivariate random effects model.ResultsOf the 12 included studies, 7 studies reported the clinical outcomes (821 patients) and 6 studies reported the diagnostic accuracy (485 patients) of IC-ECG. The pooled ORs with 95% CIs of ST-segment elevation recorded by IC-ECG were 4.65 (1.69 to 12.77), 5.08 (1.10 to 23.44), 4.53 (0.79 to 25.90) and 1.83 (0.93 to 3.62) for major adverse cardiac events, myocardial infarction, cardiac death and revascularisation, respectively. The weighted mean difference were 6.49 (95% CIs 3.84 to 9.14) for ejection fraction when ST-segment resolution was recorded, and 0.86 (95% CIs −8.55 to 10.26) when ST-segment elevation was recorded. The pooled sensitivity and specificity of ST-segment elevation were 0.78 (95% credibility intervals 0.64 to 0.89) and 0.87 (95% credibility intervals 0.75 to 0.94), respectively.ConclusionsThese findings provide quantitative data supporting that IC-ECG had promising diagnostic ability for local myocardial injury, and could predict clinical outcomes.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prognostic and diagnostic accuracy of intracoronary electrocardiogram recorded during percutaneous coronary intervention: a meta-analysis

Fan

et al. 2022

BMJ Open

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“…Intracoronary electrocardiogram (IC-ECG) ndings are sensitive and selective in detecting regional myocardial potentials [13][14][15][16][17][18]. Although the sample size in our study was small, we have found that, in the period in which the resting Pd/Pa was low, the accuracy of the IC-ECG-triggered resting index (ICE-T) was superior to the iFR in diagnosing myocardial ischemia [19].…”

Section: Introductionmentioning

confidence: 71%

Stability of Flow Velocity and Intracoronary Resistance in the Intracoronary Electrocardiogram-triggered Pressure Ratio

Nakayama

Tanaka

Uchiyama³

et al. 2021

Preprint

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It has been found that the assessment of coronary artery lesions using the fractional flow reserve and instantaneous flow reserve measurements reduces the incidence of further cardiovascular events. Here, we investigated differences in the coronary flow velocity and resistance within the analysis interval between the instantaneous flow reserve (iFR) and the intracoronary electrocardiogram (IC-ECG)-triggered distal/aortic pressure (Pd/Pa) ratio (ICE-T). Thirty-three consecutive patients with stenoses that required coronary flow measurement were enrolled. ICE-T was defined as the average Pd/Pa ratio in the period corresponding to the isoelectric line of the IC-ECG. The index value, flow velocity, and intracoronary resistance during the analysis intervals of the iFR and ICE-T, both at rest and under hyperemia, were compared. The index value and intracoronary resistance of the ICE-T were found to be significantly lower, while the flow velocity was significantly higher, than those of the iFR (P < 0.001), and all fluctuations in ICE-T values were also significantly smaller than those in the iFR.In conclusion, the ICE-T is theoretically superior to pressure-dependent indices for analyzing phases with low and stable resistance, without an increase in invasiveness.

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Association of near-infrared spectroscopy-defined lipid rich plaque with lesion morphology and peri-coronary inflammation on computed tomography angiography

Yoshizumi¹,

Hoshino²,

Sugiyama³

et al. 2022

Atherosclerosis

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Small lipid core burden index in patients with stable angina pectoris is also associated with microvascular dysfunction: Insights from intracoronary electrocardiogram

Cited by 5 publications

References 29 publications

Prognostic and diagnostic accuracy of intracoronary electrocardiogram recorded during percutaneous coronary intervention: a meta-analysis

Prognostic and diagnostic accuracy of intracoronary electrocardiogram recorded during percutaneous coronary intervention: a meta-analysis

Stability of Flow Velocity and Intracoronary Resistance in the Intracoronary Electrocardiogram-triggered Pressure Ratio

Association of near-infrared spectroscopy-defined lipid rich plaque with lesion morphology and peri-coronary inflammation on computed tomography angiography

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