Evidence of association of circulating epigenetic-sensitive biomarkers with suspected coronary heart disease evaluated by Cardiac Computed Tomography

Abstract Background Although advances in diagnosis, treatment and prognosis, coronary heart disease (CHD) is still the most prevalent cause of mortality and morbidity worldwide. Thus, there is still the need to identify both novel diagnostic and prognostic biomarkers to improve the clinical decision-making and help to stratify patients for early preventive treatment. Epigenetic-sensitive mechanisms may be related both to pathogenesis and prognosis of CHD. Among the epigenetic hallmarks, microRNAs (miRNAs), acting as flexible modulators of gene expression, could represent attractive candidate biomarkers useful in clinical practice. Purpose We prospectively investigated the expression pattern of circulating miRNAs in patients undergoing Cardiac Computed Tomography (CCT) for suspected CHD (n=95) with the aim to integrate molecular findings with morphological and clinical parameters derived by CCT. Methods CCT was performed with a third-generation dual source multidetector computed tomography scanner. Peripheral venous blood samples were collected into EDTA after a 12 h fasting in the same day of CCT, before imaging execution and the levels of 42 selected plasmatic miRNAs were analyzed by qRT-PCR. Results Let-7c-5p, miR-765, miR-483-5p, miR-31-5p and miR-206 were upregulated in CHD patients (n=66) vs healthy subjects HS (n=29) as well as let-7c-5p, miR-765, miR- 483-5p showed higher expression in obstructive CHD (n=36) compared to no obstructive CHD patients (n=66). In addition, miR-93-5p and miR-433-3p showed an upregulation in patients with critical coronary stenosis. Multivariate regression analysis demonstrated that miR-765, miR-31-5p and miR-206 were independently associated with CHD also in combination with Framingham risk score. Relevantly, miR-765, miR-93-5p and miR-433-3p were obstructive CHD predictors. ROC curve analysis also revealed a good performance for miR-765, miR-93-5p and miR-433-3p on predicting CHD severity. Circulating microRNA expression Conclusions Our study represents a combined epigenetic/imaging approach useful to support the diagnosis and prediction of CHD. Acknowledgement/Funding Italian Ministry of Health grants: “Giovani Ricercatori 2011-12” (project code GR-2011-02349436) and “Ricerca Corrente 2018”

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Noninvasive assessment of coronary atherosclerosis by cardiac computed tomography for risk stratifying patients with suspected coronary heart disease

Journal of Cardiovascular Computed Tomography ◽

10.1016/j.jcct.2019.08.009 ◽

2019 ◽

Vol 13 (5) ◽

pp. 235-241 ◽

Cited By ~ 2

Author(s):

Alexander R. van Rosendael ◽

Jeroen J. Bax ◽

Armin Arbab-Zadeh

Keyword(s):

Computed Tomography ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Atherosclerosis ◽

Cardiac Computed Tomography ◽

Noninvasive Assessment

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Cardiac computed tomography for the interventionalist

Oxford Textbook of Interventional Cardiology ◽

10.1093/med/9780198754152.003.0013 ◽

2018 ◽

pp. 177-190

Author(s):

Adriaan Coenen ◽

Laurens E. Swart ◽

Ricardo P. J. Budde ◽

Koen Nieman

Keyword(s):

Computed Tomography ◽

Coronary Heart Disease ◽

Heart Disease ◽

Computed Tomography Angiography ◽

Interventional Procedures ◽

Coronary Computed Tomography Angiography ◽

Cardiac Computed Tomography ◽

Invasive Procedure ◽

Coronary Computed Tomography ◽

Technological Developments

Coronary computed tomography angiography (CTA) is a method used to eliminate the possibility of coronary heart disease in a patient without an invasive procedure. Technological developments mean that CTA also produces less radiation than ever before, making it safer for both the patient and the practitioner. This chapter covers the principles and protocols in cardiac computed tomography (CT), guidance on interpreting the resulting images, and summarizes studies on the use of CT after various interventional procedures.

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Radiogenomics and Artificial Intelligence Approaches Applied to Cardiac Computed Tomography Angiography and Cardiac Magnetic Resonance for Precision Medicine in Coronary Heart Disease: A Systematic Review

Circulation Cardiovascular Imaging ◽

10.1161/circimaging.121.013025 ◽

2021 ◽

Author(s):

Teresa Infante ◽

Carlo Cavaliere ◽

Bruna Punzo ◽

Vincenzo Grimaldi ◽

Marco Salvatore ◽

...

Keyword(s):

Artificial Intelligence ◽

Computed Tomography ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Computed Tomography Angiography ◽

Cardiac Computed Tomography ◽

Imaging Features ◽

Cardiac Computed Tomography Angiography

The risk of coronary heart disease (CHD) clinical manifestations and patient management is estimated according to risk scores accounting multifactorial risk factors, thus failing to cover the individual cardiovascular risk. Technological improvements in the field of medical imaging, in particular, in cardiac computed tomography angiography and cardiac magnetic resonance protocols, laid the development of radiogenomics. Radiogenomics aims to integrate a huge number of imaging features and molecular profiles to identify optimal radiomic/biomarker signatures. In addition, supervised and unsupervised artificial intelligence algorithms have the potential to combine different layers of data (imaging parameters and features, clinical variables and biomarkers) and elaborate complex and specific CHD risk models allowing more accurate diagnosis and reliable prognosis prediction. Literature from the past 5 years was systematically collected from PubMed and Scopus databases, and 60 studies were selected. We speculated the applicability of radiogenomics and artificial intelligence through the application of machine learning algorithms to identify CHD and characterize atherosclerotic lesions and myocardial abnormalities. Radiomic features extracted by cardiac computed tomography angiography and cardiac magnetic resonance showed good diagnostic accuracy for the identification of coronary plaques and myocardium structure; on the other hand, few studies exploited radiogenomics integration, thus suggesting further research efforts in this field. Cardiac computed tomography angiography resulted the most used noninvasive imaging modality for artificial intelligence applications. Several studies provided high performance for CHD diagnosis, classification, and prognostic assessment even though several efforts are still needed to validate and standardize algorithms for CHD patient routine according to good medical practice.

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Integration Between Computed Tomography and Nuclear Medicine for Non-invasive Assessment of Coronary Anatomy and Myocardial Perfusion

European Cardiology Review ◽

10.15420/ecr.2012.5.2.15 ◽

2009 ◽

Vol 5 (2) ◽

pp. 15

Author(s):

Wanda Acampa ◽

Mario Petretta ◽

Carmela Nappi ◽

Alberto Cuocolo ◽

◽

...

Keyword(s):

Computed Tomography ◽

Coronary Heart Disease ◽

Blood Flow ◽

Heart Disease ◽

Myocardial Perfusion ◽

Myocardial Blood Flow ◽

Imaging Techniques ◽

Emission Computed Tomography ◽

Coronary Anatomy ◽

Non Invasive

Many non-invasive imaging techniques are available for the evaluation of patients with known or suspected coronary heart disease. Among these, computed-tomography-based techniques allow the quantification of coronary atherosclerotic calcium and non-invasive imaging of coronary arteries, whereas nuclear cardiology is the most widely used non-invasive approach for the assessment of myocardial perfusion. The available single-photon-emission computed tomography flow agents are characterised by a cardiac uptake proportional to myocardial blood flow. In addition, different positron emission tomography tracers may be used for the quantitative measurement of myocardial blood flow and coronary flow reserve. Extensive research is being performed in the development of non-invasive coronary angiography and myocardial perfusion imaging using cardiac magnetic resonance. Finally, new multimodality imaging systems have recently been developed bringing together anatomical and functional information. This article provides a description of the available non-invasive imaging techniques in the assessment of coronary anatomy and myocardial perfusion in patients with known or suspected coronary heart disease.

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The Role of Cardiovascular CT in Occupational Health Assessment for Coronary Heart Disease: An Expert Consensus Document from the Society of Cardiovascular Computed Tomography (SCCT)

Journal of Cardiovascular Computed Tomography ◽

10.1016/j.jcct.2021.03.010 ◽

2021 ◽

Author(s):

Ahmad M. Slim ◽

Emilio Fentanes ◽

Michael K. Cheezum ◽

Iain T. Parsons ◽

Christopher Maroules ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Heart Disease ◽

Heart Disease ◽

Occupational Health ◽

Health Assessment ◽

Expert Consensus ◽

Consensus Document ◽

Expert Consensus Document ◽

Cardiovascular Ct

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Abstract 11726: Novel Non-Invasive Method to Estimate Myocardial Mass at Risk Calculated From Cardiac Computed Tomography Data: Validation Study Using Angiographic Myocardial Jeopardy Scores in Patients With Single Vessel Disease

Circulation ◽

10.1161/circ.130.suppl_2.11726 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Seiko IDE ◽

Satoru Sumitsuji ◽

Kensuke Yokoi ◽

Masatoki Yoshida ◽

Isamu Mizote ◽

...

Keyword(s):

Computed Tomography ◽

At Risk ◽

Heart Disease ◽

Coronary Artery ◽

Cardiac Computed Tomography ◽

Myocardial Mass ◽

Non Invasive ◽

Vessel Disease ◽

Single Vessel ◽

Single Vessel Disease

Background: The myocardial mass at risk (MMAR), representing volume of myocardium distal to culprit lesion, is one of important factors for predicting adverse cardiac event in ischemic heart disease. However, current non-invasive cardiac imaging fails to quantify MMAR in patients with stable coronary artery disease. We have developed a new software calculating MMAR of any designated coronary artery by reconstructing the 3-dimensional-volume-data of cardiac computed tomography (CCT). The novel index, ratio of MMAR to whole left ventricular volume (%LV-MMAR), calculated with this software would be appealing to obtain MMAR objectively. This study aims to compare the %LV-MMAR with Bypass Angioplasty Revascularization Investigation (BARI) and modified Albert Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) scores, both of which are invasive angiographic methods widely used to estimate MMAR, in patients with single-vessel disease. Methods: Between April 2008 and March 2014, patients suspected of effort angina pectoris without history of previous myocardial infarction were assessed with CCT and invasive coronary angiography. Of those, 48 patients who were revealed single-vessel disease (left anterior descending artery (LAD): n=22, left circumflex artery (LCX): n=11 and right coronary artery (RCA): n=15) were included in this study. %LV-MMAR was calculated on the software. BARI and modified APPROACH score were calculated and compared with %LV-MMAR. Results: Mean %LV-MMAR was 27.6 [18.2-37.1] %. BARI and APPROACH scores showed a significant correlation (r=0.92, p<0.0001). Also, a significant correlation was observed between %LV-MMAR versus BARI and %LV-MMAR versus APPROACH (r=0.95, p<0.0001 and r=0.9, p<0.0001, respectively). %LV-MMAR showed significant correlation with BARI and APPROACH scores in all vessels; LAD (r=0.95, p<0.0001 and r=0.91, p<0.0001, respectively), LCX (r=0.91, p=0.0001 and r=0.83, p=0.0002, respectively) and RCA (r=0.92, p<0.0001 and r=0.85, p<0.0001, respectively). Conclusions: This study revealed %LV-MMAR, calculated from CCT data on novel software, to be a promising index for estimating perfusion territory noninvasively in good agreement with BARI and modified APPROACH score.

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