scholarly journals The role of IVUS and OCT in the patients with Myocardial infarction with non-obstructive coronary arteries (MINOCA)

2021 ◽  
pp. 76-83
Author(s):  
Lo Varco Aldo ◽  
Consentino Salvatore ◽  
Palmisano Maria ◽  
Lo Varco Sebastiano ◽  
Severino Carmelo
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Tissue Characterization ◽  
Plaque Rupture ◽  
Imaging Techniques ◽  
Coronary Spasm ◽  
Infrared Light ◽  
Artery Disease ◽  
Medical Radiology

The work presented describes what is meant by the term MINOCA and the causes that lead to the onset of this acute event, responsible for myocardial ischemic necrosis. Diagnosis with coronary angiography alone cannot be made since MINOCA is characterized in half of cases by the absence of hemodynamically significant lesions and therefore invasive coronary imaging performed through IVUS and OCT plays an important role. The two imaging techniques have peculiar characteristics that differentiate them from each other. IVUS uses ultrasound while OCT uses infrared light, but they are also distinguished in terms of spatial resolution, which is greater for OCT thus allowing better tissue characterization, and tissue penetration capacity which is greater for IVUS. In MINOCA patients, coronary artery imaging could help identify pathological changes that are not visible by coronary angiography such as plaque rupture, coronary dissection, coronary thromboembolism, coronary spasm, and coronary artery disease in patients presenting with Takotsubo syndrome. The use of intracoronary imaging (IVUS or OCT) can give us important information regarding the diagnosis and optimization of the treatment of patients with MINOCA, improving their prognosis. The medical radiology technician, within the Hemodynamics Team, must have a role of responsibility in the management of diagnostic images.

scholarly journals Review. Automatic Segmentation Techniques of the Coronary Artery Using CT Images in Acute Coronary Syndromes

2017 ◽  
Vol 3 (1) ◽  
pp. 9-17 ◽  
Author(s):  
Sándor Miklós Szilágyi ◽  
Monica Marton Popovici ◽  
László Szilágyi
Keyword(s):  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Vascular System ◽  
Imaging Techniques ◽  
Automatic Segmentation ◽  
Patients At Risk ◽  
Coronary Syndromes ◽  
Artery Disease ◽  
Coronary Artery Tree

AbstractCoronary artery disease represents one of the leading reasons of death worldwide, and acute coronary syndromes are their most devastating consequences. It is extremely important to identify the patients at risk for developing an acute myocardial infarction, and this goal can be achieved using noninvasive imaging techniques. Coronary computed tomography angiography (CCTA) is currently one of the most reliable methods used for assessing the coronary arteries; however, its use in emergency settings is sometimes limited due to time constraints. This paper presents the main characteristics of plaque vulnerability, the role of CCTA in the assessment of vulnerable plaques, and automatic segmentation techniques of the coronary artery tree based on CT angiography images. A detailed inventory of existing methods is given, representing the state-of-the-art of computational methods applied in vascular system segmentation, focusing on the current applications in acute coronary syndromes.

scholarly journals Peran Duke Treadmill Score sebagai Prediktor Penyakit Jantung Koroner pada Pasien dengan Uji Treadmill Positif The Role of Duke Treadmill Score as a Predictor of Coronary Artery Disease in Patients with Positive Treadmill Test Results

2016 ◽  
Vol 3 (2) ◽  
pp. 81
Author(s):  
Muhammad Ikhsan ◽  
Sally Aman Nasution ◽  
Ika Prasetya Wijaya ◽  
Cleopas Martin Rumende
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Negative Likelihood Ratio ◽  
Receiver Operator Curve ◽  
Treadmill Test ◽  
Duke Treadmill Score ◽  
Artery Disease ◽  
Operator Curve

Pendahuluan. Coronary Artery Disease (CAD) merupakan penyakit yang masih menjadi penyebab utama morbiditas dan mortalitas di dunia. Uji treadmill merupakan modalitas diagnostik untuk CAD yang tersedia secara luas di Indonesia, namun performa ketepatan diagnostiknya masih perlu ditingkatkan. Penelitian yang dilakukan ini menggunakan Duke Treadmill Score (DTS) sebagai prediktor Coronary Artery Disease.Metode. Penelitian ini menggunakan desain studi potong lintang yang dilakukan pada subjek dengan CAD stabil berusia 18-75 tahun yang menjalani uji treadmill dengan hasil positive ischemic response dan sudah dilakukan korangiografi di Poliklinik Pelayanan Jantung Terpadu Rumah Sakit dr. Cipto Mangunkusumo (RSCM) dalam kurun waktu Januari 2011 hingga Desember 2013.Hasil. Didapatkan 103 subjek dengan 37,9% diagnosis CAD signifikan dari corangiografi. Dari ROC (Receiver Operator Curve) ditentukan titik potong DTS pada nilai -8,85. Didapatkan nilai sensitivitas, spesifisitas, nilai duga positif (NDP) dan nilai duga negatif (NDN) DTS masing-masing sebesar 28% (IK 95%: 17%-44%), 95% (IK 95%: 87%-98%), 79% (IK 95%: 52%-92%) dan 69% (IK 95%: 58%-77%).Simpulan. Disimpulkan DTS dapat memprediksi CAD yang signifikan pada titik potong -8,85 untuk pasien uji treadmill positif dengan nilai duga positif yang cukup baik.Kata Kunci: CAD, DTS, uji treadmillThe Role of Duke Treadmill Score as a Predictor of Coronary Artery Disease in Patients with Positive Treadmill Test ResultsIntroduction. Coronary Artery Disease (CAD) is one of the disease entity that leading cause of morbidity and mortality in worldwide. Treadmill test is part of the diagnostic modality which readily available to assess possibility of narrowing coronary artery and guiding us whether we need for the further investigation. Despite of that, treadmill test has limitation in diagnostic accuracy. Duke Treadmill Score (DTS) was also tested as a diagnostic score, and shown to predict significant CAD better than the ST-segment response alone.Methods. This is a cross-sectional study performed in adult patients with stable CAD that underwent treadmill test and coronary angiography in outward patient clinic of the Integrated Cardiac Service in Cipto Mangunkusumo Hospital between January 2011 and December 2013.Results. A total of 103 patients in this study, thirty nine patients (37,9 %) had significant CAD in coronary angiography. Briefly, mean age was 54,71 years and 55 patients (53,4 %) were females. The most common CAD risk factor was hypertension (51,5 %). A mean of DTS score was -3.53, which mostly categorized as intermediate risk (89,3 %). Based on DTS results, cut-off point was determined by using Receiver Operator Curve (ROC) method, in which value of -8,85 considering as a cut-off point. Sensitivity and specificity value of DTS were 28 % (CI 95 %: 17 % to 44 %), and 95 % (CI 95 %: 87 % to 98 %). Positive and negative predictive value were 79 % (CI 95 %: 52 % to 92 %) and 69 % (CI 95 %: 58 % to 77 %). Positive and negative likelihood ratio were 6.02 and 0.75.Conclusions. DTS has a good performance in predicting significant CAD at cut-off point -8,85 in patients with positive treadmill test.Keywords: CAD, DTS, treadmill test

scholarly journals Article Commentary: Predictive Value of Absent Septal q Wave in Patients with Significant Stenosis of Proximal Left Anterior Descending Coronary Artery

2010 ◽  
Vol 4 ◽  
pp. CMC.S5135 ◽  
Author(s):  
Saeed Alipour Parsa ◽  
Anahita Shahnazi ◽  
Azadeh Malek ◽  
Eznollah Azargashb ◽  
Manijeh Mohammadi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Predictive Value ◽  
Kappa Statistic ◽  
Descriptive Study ◽  
Exact Role ◽  
Significant Stenosis ◽  
Artery Disease ◽  
Q Wave

Aims There is conflicting data about the predictive value of absent septal q wave in patients with significant stenosis of proximal Left Anterior Descending coronary artery. To clarify the exact role of this simple electrocardiographic sign we conducted this prospective descriptive study. Methods Patients who were referred for coronary angiography in Milad Hospital between December 2008 and September 2009 were chosen randomly. Standard ECG was performed and reviewed for presence or absence of septal q wave, and then the coronary angiography was done and reported by another cardiologist. Results Of 148 patients with absent septal q wave in ECG, 85 patients (57%) had significant stenosis of proximal LAD in coronary angiography. Statistical analysis showed that significant stenosis of proximal LAD could be predicted by absence of septal q wave in ECG with sensitivity of 59% and specificity of 47%. However, Kappa statistic (Kappa = 0.36) showed low agreement between them. Conclusion Absence of normal septal q wave in ECG could be a low value predictor of coronary artery disease mainly significant proximal LAD stenosis.

Coronary artery disease: from atherosclerosis to obstructive disease, inducible ischaemia, and the ischaemic cascade

ESC CardioMed ◽  
2018 ◽  
pp. 1331-1339
Author(s):  
Jeroen J. Bax
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Atherosclerosis ◽  
Imaging Techniques ◽  
Invasive Coronary Angiography ◽  
Non Invasive ◽  
Anatomical Imaging ◽  
Artery Disease ◽  
Ischaemic Cascade

The inclusion or exclusion of coronary artery disease is important for patient management, both from a diagnostic and prognostic view, as well as from a therapeutic view. Various detection techniques are available, including invasive (coronary angiography) or non-invasive imaging techniques. The techniques can also be divided into anatomical imaging or functional imaging, where anatomical imaging detects coronary atherosclerosis and stenosis (invasive coronary angiography, but also non-invasive coronary angiography—performed with multidetector computed tomography), while functional imaging (nuclear imaging, stress echocardiography, and cardiovascular magnetic resonance) detects ischaemia: the haemodynamic consequences of the atherosclerosis/stenosis. The early phase of atherosclerotic coronary artery disease is often asymptomatic (and anatomical imaging can be used to detect/exclude coronary atherosclerosis), whereas with progression of atherosclerotic disease, symptoms occur related to myocardial ischaemia. Non-invasive imaging can facilitate in the detection of both early (asymptomatic) and more advanced (symptomatic, ischaemic) coronary artery disease. The pathophysiological cascade of cardiac abnormalities that occur once ischaemia is induced is referred to as the ischaemic cascade. The ischaemic cascade consists of chronological development of perfusion abnormalities, followed by diastolic dysfunction, then systolic dysfunction, and finally electrocardiographic abnormalities. In this chapter, the variety of the different non-invasive imaging techniques to assess the different phases of the non-ischaemic part and the ischaemic part (ischaemic cascade) of coronary artery disease are described.

The role of plaque rupture and thrombosis in coronary artery disease

2000 ◽  
Vol 149 (2) ◽  
pp. 251-266 ◽  
Author(s):  
A.G Zaman ◽  
G Helft ◽  
S.G Worthley ◽  
J.J Badimon
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Plaque Rupture ◽  
Artery Disease
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