scholarly journals Quantitative evaluation and comparison of coronary artery characteristics by 3D coronary volume reconstruction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yongcheol Kim ◽  
Jonathan James Hyett Bray ◽  
Benjamin Waterhouse ◽  
Alexander Gall ◽  
Georgia May Connolly ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Intraclass Correlation ◽  
Quantitative Coronary Angiography ◽  
Volume Estimation ◽  
Diabetic Patients ◽  
Volume Reconstruction ◽  
3 Dimensional ◽  
Inter Observer Variability

AbstractNon-atherosclerotic abnormalities of vessel calibre, aneurysm and ectasia, are challenging to quantify and are often overlooked in qualitative reporting. Utilising a novel 3-dimensional (3D) quantitative coronary angiography (QCA) application, we have evaluated the characteristics of normal, diabetic and aneurysmal or ectatic coronary arteries. We selected 131 individuals under 50 years-of-age, who had undergone coronary angiography for suspected myocardial ischaemia between 1st January 2011 and 31st December 2015, at the Bristol Heart Institute, Bristol, UK. This included 42 patients with angiographically normal coronary arteries, 36 diabetic patients with unobstructed coronaries, and 53 patients with abnormal coronary dilatation (aneurysm and ectasia). A total of 1105 coronary segments were analysed using QAngio XA 3D (Research Edition, Medis medical imaging systems, Leiden, The Netherlands). The combined volume of the major coronary arteries was significantly different between each group (1240 ± 476 mm3 diabetic group, 1646 ± 391 mm3 normal group, and 2072 ± 687 mm3 abnormal group). Moreover, the combined coronary artery volumes correlated with patient body surface area (r = 0.483, p < 0.01). Inter-observer variability was assessed and intraclass correlation coefficient of the total coronary artery volume demonstrated a low variability of 3D QCA (r = 0.996, p < 0.001). Dedicated 3D QCA facilitates reproducible coronary artery volume estimation and allows discrimination of normal and diseased vessels.

Quantification of Coronary Artery Stenosis with 16-Slice MSCT in Patients before CABG Surgery: Comparison to Standard Invasive Coronary Angiography

2005 ◽  
Vol 8 (1) ◽  
pp. 42 ◽  
Author(s):  
C. Probst ◽  
A. Kovacs ◽  
C. Schmitz ◽  
W. Schiller ◽  
H. Schild ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Invasive Coronary Angiography ◽  
Bypass Graft ◽  
Heart Association ◽  
Artery Stenosis ◽  
Vessel Disease ◽  
Selective Coronary Angiography

Objective: Invasive, selective coronary angiography is the gold standard for evaluation of coronary artery disease (CAD) and degree of stenosis. The purpose of this study was to compare 3-dimensional (3D) reconstructed 16-slice multislice computed tomographic (MSCT) angiography and selective coronary angiography in patients before elective coronary artery bypass graft (CABG) procedure. Methods: Sixteen-slice MSCT scans (Philips Mx8000 IDT) were performed in 50 patients (42 male/8 female; mean age, 64.44 8.66 years) scheduled for elective CABG procedure. Scans were retrospectively electrocardiogram-gated 3D reconstructed. The images of the coronary arteries were evaluated for stenosis by 2 independent radiologists. The results were compared with the coronary angiography findings using the American Heart Association segmental classification for coronary arteries. Results: Four patients (8%) were excluded for technical reasons. Thirty-eight patients (82.6%) had 3-vessel disease, 4 (8.7 %) had 2-vessel disease, and 4 (8.7%) had an isolated left anterior descending artery stenosis. In the proximal segments all stenoses >50% (56/56) were detected by MSCT; medial segment sensitivity was 97% (73/75), specificity 90.3%; distal segment sensitivity was 90.7% (59/65), specificity 77%. Conclusion: Accurate quantification of coronary stenosis greater than 50% in the proximal and medial segments is possible with high sensitivity and specificity using the new generation of 16-slice MSCTs. There is still a tendency to overestimate stenosis in the distal segments. MSCT seems to be an excellent diagnostic tool for screening patients with possible CAD.

scholarly journals Immunoglobulin G4-related masses surrounding coronary arteries: a case report

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Takuya Nakamura ◽  
Yutaka Goryo ◽  
Takuya Isojima ◽  
Hiroyuki Kawata
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiovascular System ◽  
Coronary Arteries ◽  
Elevated Serum ◽  
High Serum ◽  
Immunoglobulin G4 ◽  
Coronary Arteritis ◽  
Serum Igg4 ◽  
Mass Formation

Abstract Background Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition with high serum IgG4 levels affecting various organs, such as the pancreas, lacrimal and salivary glands, thyroid, kidney, and lung. Typical cardiovascular manifestations of IgG4-RD include periaortitis, coronary arteritis, and pericarditis. However, reports of IgG4-RD associated with coronary arteritis are rare. Here, we report a case of IgG4-related masses surrounding the coronary arteries. Case summary A 59-year-old man was referred to our hospital because of mediastinal masses detected by computed tomography (CT). Coronary CT angiography revealed masses surrounding the right coronary artery and the left anterior descending coronary artery. An elevated serum level of IgG4 and histological findings led to the diagnosis of IgG4-related coronary arteritis with mass formation. Coronary angiography showed numerous feeding arteries to the masses, which were demonstrated as multiple microchannels in the intravascular ultrasound (IVUS) images. Discussion IgG4-RD involving the cardiovascular system has been reported. However, coronary artery disease associated with IgG4-RD is very rare, and the mechanism of mass formation in IgG4-related coronary arteritis is unclear. In our case, within the cardiovascular system, IgG4-RD was limited to the coronary arteries, suggesting that the affected coronary arteries may provide the necessary blood supply to the mass, thus, aiding its growth. These findings were supported by the images from coronary angiography and IVUS.

scholarly journals Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Murat Yuksel ◽  
Abdulkadir Yildiz ◽  
Mustafa Oylumlu ◽  
Nihat Polat ◽  
Halit Acet ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Ventricle ◽  
Coronary Arteries ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Ventricular Rate ◽  
Fistula Formation ◽  
New Onset

Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF) with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

P873Plasma PCSK9 levels and atherosclerosis burden in the coronary arteries of patients undergoing coronary angiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Panahi ◽  
M S Ghahrodi ◽  
M S Jamshir ◽  
M A Safarpour ◽  
M Pirro ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Coronary Stenosis ◽  
Coronary Vessels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Vessel Disease ◽  
Coronary Calcifications ◽  
Triple Vessel Disease

Abstract Background Plasma PCSK9 levels, a novel and effective therapeutic target for CVD prevention, have been associated with CVD events irrespective of traditional risk factors. Whether PCSK9 levels predict coronary artery disease (CAD) burden and severity is a matter of dispute. Purpose To investigate the association between plasma PCSK9 levels and CAD characteristics, including number of major diseased vessels, severity of coronary stenosis, and the burden of coronary calcifications. Methods One hundred and one patients undergoing coronary angiography were recruited for this cross-sectional study. The number of major coronary diseased vessels was defined as the presence of ≥1 stenoses ≥50% in diameter of at least one major coronary artery. CAD severity was defined as either the absence of coronary stenosis (no-CAD), CAD<50% or CAD≥50% in one or more coronary arteries. The burden of coronary calcifications was estimated by angiography visual inspection and classified as absent, mild, moderate or severe. Results Coronary angiography showed single, double and triple vessel disease in 26 (25.7%), 23 (22.8%) and 21 (20.8%) patients, respectively; 20 (19.8%) and 11 (10.9%) pts had either minimal CAD (<50%) or normal angiographic findings. Also, calcifications were absent in 65 patients (64.4%), and mild, moderate and severe in 23 (22.8%), 11 (10.9%) and 2 (2%) patients, respectively. Plasma PCSK9 levels were significantly associated with age (rho=0.22, p=0.025) and SBP (rho=0.21, p=0.034), and were almost doubled in patients with chronic kidney disease (CKD) as compared to those without CKD [164.6 ng/mL (104.6–187.0) vs 94.8 ng/mL (86.8–114.9), p=0.006]. Among patients without CKD, those with CAD≥50% had higher plasma PCSK9 levels than those without [97.1 ng/mL (87.8–143.0) vs 83.2 ng/mL (73.4–102.6), p=0.04]. In the overall population, higher plasma PCSK9 levels were found in pts with triple vessel disease [165.7 ng/mL (121.3–180.5)] than in those with double/single vessel involvement [97.9 ng/mL (87.6–99.8) and 88.4 ng/mL (87.3–97.4), p<0.001 for both comparisons] or without CAD [87.5 ng/mL (74.3–114.9), p<0.001]. Also, a trend toward an increase of plasma PCSK9 levels was found with higher CAD severity [no-CAD: 87.5 ng/mL (74.3–114.9), CAD<50%: 89.1 ng/mL (78.9–105.3), CAD≥50%: 97.6 ng/mL (87.9–155.3), p=0.051], which turned significant after exclusion of CKD patients (p=0.042). Adjustment for age, sex, plasma LDL-cholesterol levels, statin use and CKD abolished the association between PCSK9 and CAD severity but not with the number of significantly diseased vessels and the burden of coronary calcifications. Conclusions Circulating PCSK9, whose plasma levels are significantly influenced by the presence of CKD, discriminates patients with significant coronary artery stenosis from those without CAD. In addition, both the number of diseased coronary vessels and total coronary calcifications are independently predicted by an elevated plasma PCSK9 level. Acknowledgement/Funding None

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