scholarly journals Identifying Coronary Artery Lesions by Feature Analysis of Radial Pulse Wave: A Case-Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Chun-ke Zhang ◽  
Lu Liu ◽  
Wen-jie Wu ◽  
Yi-qin Wang ◽  
Hai-xia Yan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Time Domain ◽  
Pulse Wave ◽  
Multiscale Entropy ◽  
Lesion Group ◽  
Control Group ◽  
Radial Pulse ◽  
Coronary Artery Lesions ◽  
Average Precision

Background. Cardiovascular diseases have been always the most common cause of morbidity and mortality worldwide. Health monitoring of high-risk and suspected patients is essential. Currently, invasive coronary angiography is still the most direct and accurate method of determining the severity of coronary artery lesions, but it may not be the optimal clinical choice for suspected patients who had clinical symptoms of coronary heart disease (CHD) such as chest pain but no coronary artery lesion. Modern medical research indicates that radial pulse waves contain substantial pathophysiologic information about the cardiovascular and circulation systems; therefore, analysis of these waves could be a noninvasive technique for assessing cardiovascular disease. Objective. The objective of this study was to analyze the radial pulse wave to construct models for assessing the extent of coronary artery lesions based on pulse features and investigate the latent value of noninvasive detection technology based on pulse wave in the evaluation of cardiovascular disease, so as to promote the development of wearable devices and mobile medicine. Method. This study included 529 patients suspected of CHD who had undergone coronary angiography. Patients were sorted into a control group with no lesions, a 1 or 2 lesion group, and a multiple (3 or more) lesion group as determined by coronary angiography. The linear time-domain features and the nonlinear multiscale entropy features of their radial pulse wave signals were compared, and these features were used to construct models for identifying the range of coronary artery lesions using the k -nearest neighbor (KNN), decision tree (DT), and random forest (RF) machine learning algorithms. The average precision of these algorithms was then compared. Results. (1) Compared with the control group, the group with 1 or 2 lesions had increases in their radial pulse wave time-domain features H2/H1, H3/H1, and W2 ( P < 0.05 ), whereas the group with multiple lesions had decreases in MSE1, MSE2, MSE3, MSE4, and MSE5 ( P < 0.05 ). (2) Compared with the 1 or 2 lesion group, the multiple lesion group had increases in T1/T ( P < 0.05 ) and decreases in T and W1 ( P < 0.05 ). (3) The RF model for identifying numbers of coronary artery lesions had a higher average precision than the models built with KNN or DT. Furthermore, average precision of the model was highest (80.98%) if both time-domain features and multiscale entropy features of radial pulse signals were used to construct the model. Conclusion. Pulse wave signal can identify the range of coronary artery lesions with acceptable accuracy; this result is promising valuable for assessing the severity of coronary artery lesions. The technique could be used to development of mobile medical treatments or remote home monitoring systems for patients suspected or those at high risk of coronary atherosclerotic heart disease.

scholarly journals Research on the correlation between activating transcription factor 3 expression in the human coronary artery and atherosclerotic plaque stability

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. Peng ◽  
C. Y. Le ◽  
B. Xia ◽  
J. W. Wang ◽  
J. J. Liu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Necrotic Core ◽  
Inflammatory Factors ◽  
Lesion Group ◽  
Control Group ◽  
Atherosclerotic Plaques ◽  
Activating Transcription Factor 3 ◽  
Fibrous Cap ◽  
Fibrous Cap Thickness ◽  
Activating Transcription Factor

Abstract Background Activating transcription factor 3 (ATF3) is an early response gene that is activated in response to atherosclerotic stimulation and may be an important factor in inhibiting the progression of atherosclerosis. In this study, we directly measured the expression of ATF3 and inflammatory factors in human coronary atherosclerotic plaques to examine the relationship between ATF3 expression, inflammation and structural stability in human coronary atherosclerotic plaques. Methods A total of 68 coronary artery specimens were collected from the autopsy group, including 36 cases of sudden death from coronary heart disease (SCD group) and 32 cases of acute death caused by mechanical injury with coronary atherosclerosis (CHD group). Twenty-two patients who had no coronary heart disease were collected as the control group (Con group). The histological structure of the coronary artery was observed under a light microscope after routine HE staining, and the intimal and lesion thicknesses, thickness of the fibrous cap, thickness of necrosis core, degree of lumen stenosis were assessed by image analysis software. Western blotting and immunohistochemistry were used to measure the expression and distribution of ATF3, inflammatory factors (CD45, IL-1β, TNF-α) and matrix metalloproteinase-9 (MMP-9) and vascular cell adhesion molecule 1 (VCAM1) in the coronary artery. The Pearson correlation coefficient was used to analyse the correlation between ATF3 protein expression and inflammatory factors and between ATF3 protein expression and structure-related indexes in the lesion group. Results Compared with those in the control group, the intima and necrotic core in the coronary artery were thickened, the fibrous cap became thin and the degree of vascular stenosis was increased in the lesion group, while the intima and necrotic core became thicker and the fibrous cap became thinner in the SCD group than in the CHD group (P < 0.05). There was no or low expression of ATF3, inflammatory factors, VCAM1 and MMP-9 in the control group, and the expression of inflammatory factors, VCAM1 and MMP-9 in the SCD group was higher than that in CHD group, while the expression of ATF3 in the SCD group was significantly lower than that in CHD group (P < 0.05). In the lesion group, the expression of ATF3 was negatively correlated with intimal and necrotic focus thickness, positively correlated with fibrous cap thickness (P < 0.01), and negatively correlated with inflammatory factors, VCAM1 and MMP-9 (P < 0.01). Conclusions The expression of ATF3 may be related to the progression and stability of atherosclerotic plaques, and may affect the structural stability of atherosclerotic plaques by regulating the inflammatory response, thus participating in the regulation of atherosclerotic progression.

Clinical Implication of Carotid-Radial Pulse Wave Velocity for Patients with Coronary Artery Disease

2006 ◽  
Vol 36 (8) ◽  
pp. 565 ◽  
Author(s):  
Young-Soo Lee ◽  
Kee-Sik Kim ◽  
Chang-Wook Nam ◽  
Seong-Wook Han ◽  
Seung-Ho Hur ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Clinical Implication ◽  
Pulse Wave ◽  
Radial Pulse ◽  
Artery Disease

Plasma Lipoprotein(a) Values and Severity of Coronary Artery Disease in a Large Population of Patients Undergoing Coronary Angiography

1992 ◽  
Vol 38 (11) ◽  
pp. 2261-2266 ◽  
Author(s):  
C Labeur ◽  
D De Bacquer ◽  
G De Backer ◽  
J Vincke ◽  
L Muyldermans ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Stenosis ◽  
Large Population ◽  
Univariate Analysis ◽  
Confounding Factors ◽  
Coronary Artery Lesions ◽  
Male And Female ◽  
Lipoprotein A ◽  
Artery Disease

Abstract To determine possible associations between lipoprotein(a) [Lp(a)] and the severity of coronary artery lesions, we measured lipid, apolipoprotein, and Lp(a) in a large population of Belgian patients (n = 1054) undergoing coronary angiography. In both women and men, univariate analysis demonstrated significant differences in the Lp(a) concentrations according to the severity of the coronary stenosis. However, after adjustment for possible confounding factors, many of these differences were attenuated, indicating that other variables that differentiate patients from control subjects also influence Lp(a) distribution. Differences in lipid, apolipoprotein, and Lp(a) concentrations between male and female patients are discussed.

scholarly journals Relationship between Different Degrees of Compression and Clinical Symptoms in Patients with Myocardial Bridge and the Risk Factors of Proximal Atherosclerosis

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jiaxi Zhang ◽  
Fei Duan ◽  
Zhihong Zhou ◽  
Li Wang ◽  
Yang Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Clinical Symptoms ◽  
Proximal Part ◽  
Control Group ◽  
Myocardial Bridge ◽  
Atherosclerotic Stenosis ◽  
Proximal Coronary Artery ◽  
The Relationship

Objective. To explore the relationship between different degrees of compression and clinical symptoms in patients with the myocardial bridge and the risk factors of proximal atherosclerosis. Methods. The clinical data of 156 patients with the myocardial bridge who underwent selective coronary angiography in our hospital from December 2010 to December 2015 were collected. The patients were divided into Noble grade I group (102 cases) and Noble grades II-III group (54 cases) according to the degree of mural coronary artery systolic stenosis. According to the results of coronary angiography, 156 patients with the myocardial bridge were divided into an atherosclerosis group (the myocardial bridge combined with atherosclerosis at the proximal end of the myocardial bridge of simple wall coronary artery), 91 cases, and a control group (isolated myocardial bridge), 65 cases. The relationship between different degrees of compression and clinical symptoms in patients with the myocardial bridge was observed, and the logistic regression model was used to analyze the risk factors of proximal atherosclerosis in patients with the myocardial bridge. Results. The incidence of atherosclerotic stenosis, angina pectoris, and myocardial infarction in the proximal part of the myocardial bridge in the Noble grades II-III group was higher than that in the Noble grade I group ( P < 0.05 ). The differences in age, hypertension, and Noble classification between the two groups were statistically significant ( P < 0.05 ). The differences of total cholesterol (TC) and C-reactive protein (CRP) between the two groups were statistically significant ( P < 0.05 ). Multivariate analysis showed that age, hypertension, Noble grade, and CRP were all risk factors for proximal atherosclerosis in patients with the myocardial bridge ( P < 0.05 ). Conclusion. The more severe the compression of the myocardial bridge, the greater the risk of cardiovascular events for patients and the higher the incidence of atherosclerotic stenosis in the proximal part of the myocardial bridge. In addition, the occurrence of atherosclerosis in the proximal coronary artery of the myocardial bridge may be affected by age, hypertension, Noble grade, and CRP level.

scholarly journals Comparative characteristics of coronary artery damage in different degree of ischemic mitral regurgitation

2019 ◽  
Vol 18 (4) ◽  
pp. 45-50
Author(s):  
V. V. Krylov
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Mitral Regurgitation ◽  
Ischemic Heart Disease ◽  
Myocardial Revascularization ◽  
Ischemic Mitral Regurgitation ◽  
Ischemic Heart ◽  
Military Hospital ◽  
Coronary Artery Lesions

Introduction. Despite an active study of the problem of ischemic mitral regurgitation, studies of its connections with the degree and localization of coronary artery lesions are contradictory.Objective. Study the features of coronary artery lesions according to coronary angiography in patients with ischemic heart disease and ischemic mitral regurgitation and the connections between the severity of coronary artery lesions and the degree of ischemic mitral regurgitation.Material and methods. A retrospective analysis of the results of the examination of 86 patients with various forms of ischemic heart disease in combination with ischemic mitral regurgitation, operated in the department of cardiovascular surgery of the P.V. Mandryka Central Military Hospital. Results. 89,5 % of patients showed multifocal atherosclerotic coronary artery lesions, requiring direct myocardial revascularization; the predominant type of coronary blood supply was right (82,6 %); the average number of affected main coronary arteries was 2,2±1,1, the average total degree of coronary artery lesion was 42,3±25,1 %.Conclusion. 1. The connections between the degree of ischemic mitral regurgitation and the severity and localization of coronary artery lesions was not revealed. 2. The degree of ischemic mitral regurgitation determined primarily by the progression of ischemic remodeling of the left ventricle. 3. Coronary angiography data cannot be a criterion for determining the degree of ischemic mitral regurgitation, however, they are necessary for determining the surgical tactics of direct myocardial revascularization.

scholarly journals Serum Lp-PLA2 Level Predicting Coronary Artery Lesions in Children with Kawasaki Disease

2021 ◽  
Vol 24 (4) ◽  
pp. E611-E618
Author(s):  
Xiong Zhang ◽  
Ya-Wang Shao ◽  
Ya-Lan Zhang ◽  
Yi Liu
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Color Doppler ◽  
Intima Media Thickness ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Healthy Children ◽  
Coronary Artery Lesions ◽  
Cell Counts ◽  
Ifn Γ

Background: Kawasaki disease (KD) is an inflammatory disease associated with coronary vasculitis in children. In this study, we explored the correlation between Lipoprotein associated phospholipase A2 (Lp-PLA2) and coronary artery lesions (CAL) in children with KD. Methods: Ninety-three children with KD were divided into a normal coronary artery (NCA, 54 cases) group and coronary artery lesions (CAL, 39 cases) group, according to the results of echocardiography. Another 42 healthy children were selected as the control group. The serumal levels of Lp-PLA2, Interferon-γ(IFN-γ) and Interleukin-6 (IL-6) were determined by using an enzyme-linked immunosorbent assay. In addition, erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) level were analyzed. The left main coronary artery (LMCA), diameters of left anterior descending coronary artery (LADC), right proximal coronary artery (PRCA), and carotid intima-media thickness (IMT) were obtained by color Doppler ultrasound. The correlation between the above indexes and KD was analyzed. Results: The levels of white blood cell counts (WBC), ESR, CRP, IFN-γ, IL-6 and Lp-PLA2 as well as IMT were significantly increased in KD children (P < 0.05), and the levels of CRP, IFN-γ, IL-6 and Lp-PLA2 as well as IMT in the CAL group increased more significantly (P < 0.05). An increasing trend also has been described in the diameters of LMCA, LADC and PRCA for KD children with CAL compared with with NCA. The results of logistic regression analysis showed that the elevated levels of CRP, IFN-γ, IL-6 and Lp-PLA2 were independent risk factors for KD with CAL. Correlation analysis showed that Lp-PLA2 level was positively correlated with the levels of IFN-γ, IL-6 and CRP in CAL group and NCA group (respectively, all P < 0.01). In addition, a similar correlation was also described between Lp-PLA2 level and the diameters of LMCA, LADC and PRCA in CAL group (respectively, all P < 0.01). Conclusion: Lp-PLA2 may participate in the pathological mechanism of KD. Detection of the serum Lp-PLA2 level can be used in the diagnosis of KD disease and the assessment of coronary artery lesions in KD children.

Electrocardiographic predictors of proximal left anterior descending coronary artery occlusion

Open Medicine ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. 294-299
Author(s):  
Javad Kojuri ◽  
Amir Vosoughi ◽  
Shahdad Khosropanah ◽  
Amir Aslani
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Proximal Part ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Control Group ◽  
Lower Sensitivity ◽  
Anterior Myocardial Infarction ◽  
St Depression

AbstractProximal occlusion of the left anterior descending coronary artery (LAD) results in a less favorable prognosis in coronary angiography. Therefore, it is important to determine whether there are significant lesions in LAD by electrocardiography (ECG) before coronary angiography. Twelve-lead ECG was compared in 130 patients with significant lesions (≥70% stenosis) confined to proximal part of the LAD (P LAD group) and 492 patients with normal coronary angiography (control group). Fifty-nine patients in the P LAD group and 18 patients in the control group had signs of anterior myocardial infarction as shown by ST elevation (≥1.0 mV) in two consecutive pericardial leads or the presence of a pathological Q wave. An inverted U wave (biphasic T wave) in leads V1 to V4 had a sensitivity of 49.3% (35/71) in P LAD patients without signs of anterior myocardial infarction (MI) and 96.6 % (57/59; specificity, 66.6%; positive predictive value, 90.9 %) in the P LAD patients with signs of anterior MI. In the P LAD patients with signs of anterior MI, T inversion in V4–V5 had a lower sensitivity (67.0% [40/59]) than an inverted U wave. ST depression in inferior leads and ST depression in V5 were not useful markers of proximal LAD occlusion. In conclusions, an inverted U wave in V1 to V4 (or in each of these leads) and T inversion in V4–V5 are the best predictors of significant proximal LAD lesion, especially in patients with ECG findings of anterior MI.

scholarly journals The Effectiveness of Peer Group-Based Training on the Outcomes of Patients Undergoing Transradial Coronary Angiography

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ahmad Reza Dehghan ◽  
Zhila Fereidouni ◽  
Majid Najafi Kalyani
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Peer Group ◽  
Anxiety And Depression ◽  
Control Group ◽  
Peer Training ◽  
Coronary Artery Angiography ◽  
Significant Difference ◽  
The Mean

Introduction. Coronary artery angiography using radial artery is one of the methods used for diagnosis of coronary artery disease, which causes physical and psychological problems in patients despite its precise and definite diagnosis. The present study is aimed at investigating the effect of peer group-based education on physical and psychological outcomes of patients undergoing coronary artery angiography through the radial artery. Methodology. The present clinical study was conducted on 60 patients undergoing coronary angiography through the radial artery in Vali-e-Asr educational hospital of Fasa during 2018 to 2019. The participants were divided into peer training and control groups (n=30 in each group) using permutated block randomization. In the peer training group, the patients received the necessary precare training through peer training during and after angiography care. In the control group, the patients received the routine care by the nurse of the related ward. The peer group’s stress, anxiety, and depression levels were evaluated before and after the training. Indeed, their comfort, tolerance, satisfaction, and pain levels were measured by a nurse after angiography at the time of entering the ward. Findings. The results indicated no significant difference between the two groups regarding the mean scores of stress, anxiety, and depression before the intervention (p>0.05). After the intervention, however, there was a significant difference between the two groups concerning the mean score of anxiety (p<0.05). Nonetheless, no significant difference was found between the two groups in terms of tolerance, comfort, satisfaction, and pain levels (p>0.05). Finally, the level of pain decreased in both groups over time (p<0.001). Conclusion. Peer group-based training was effective in decreasing the mean score of anxiety in the patients undergoing coronary angiography. Thus, this method is recommended to be utilized alongside other methods to train patients before coronary angiography due to its inexpensiveness and lack of side effects as well as not increasing the nurses’ workload.

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