Coronary Heart Disease Imaging

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 2489

Special Issue Editor


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Guest Editor
Cardiovascular Center, OLV Clinic, 9300 Aalst, Belgium
Interests: cardiac CT; intravascular imaging; coronary artery physiology; heart imaging

Special Issue Information

Dear Colleagues, 

Novel non-invasive and invasive modalities have enriched the field of coronary imaging. Imaging modalities for diagnosis and treatment of coronary artery disease comprise coronary CT angiography, conventional angiography, intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS) and optical coherence tomography (OCT). Developments in coronary imaging are likely to result in improved diagnosis in patients with coronary artery disease. The use of these tools as adjunct methods to guide medical therapy or percutaneous coronary interventions is likely to improve clinical outcomes. Moreover, the advent of artificial intelligence may further increase the value of coronary imaging modalities.

The Special Issue of Diagnostics with a focus on “Coronary Artery Disease Imaging” invites submission of the recent advances, current possibilities, and emerging techniques in coronary imaging.

Dr. Carlos Collet
Guest Editor

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Published Papers (1 paper)

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Research

13 pages, 1828 KiB  
Article
Hidden Coronary Atherosclerosis Assessment but Not Coronary Flow Reserve Helps to Explain the Slow Coronary Flow Phenomenon in Patients with Angiographically Normal Coronary Arteries
by Carlo Caiati, Fortunato Iacovelli, Giandomenico Mancini and Mario Erminio Lepera
Diagnostics 2022, 12(9), 2173; https://doi.org/10.3390/diagnostics12092173 - 8 Sep 2022
Cited by 9 | Viewed by 2123
Abstract
The significance of the slow coronary flow phenomenon (SCFph), as visualized in patients (pts) with angiographically normal coronary arteries, is controversial. Absolute coronary flow reserve (CFR) in the left anterior descending coronary artery (LAD), non-invasively assessed by a transthoracic color-guided pulsed-wave Doppler (E-Doppler [...] Read more.
The significance of the slow coronary flow phenomenon (SCFph), as visualized in patients (pts) with angiographically normal coronary arteries, is controversial. Absolute coronary flow reserve (CFR) in the left anterior descending coronary artery (LAD), non-invasively assessed by a transthoracic color-guided pulsed-wave Doppler (E-Doppler TTE), is a reliable parameter to assess coronary microcirculatory dysfunction (CMD). Mild and angiographically hidden epicardial atherosclerosis (Hath), as visualized by intracoronary ultrasound (IVUS), which could be the clue to atherosclerotic coronary microvascular involvement, has never been investigated together with CFR in patients. This study was aimed at assessing the value of CFR and HA in explaining the SCFph. Methods. Both non-invasive assessment of CFR in the LAD and corrected TIMI frame count assessment of the coronary contrast runoff were performed in 124 pts with angiographically normal coronary arteries. Among the whole group, 32 patients also underwent intracoronary ultrasounds in the LMCA and LAD, and the maximal plaque burden was assessed (Lesion external elastic (EEM) cross sectional area (CSA)—Lesion Lumen CSA/Lesion EEM CSA * 100). We found that 24 of the 124 pts (group 1) had the SCFph and the remaining 100 had a normal runoff (group 2). CFR, evaluated in both groups, was not significantly different, being 2.79 ± 0.79 (Mean ± SD) in group 1 and 2.90 ± 0.8 in group 2 (p = ns); in the pts also examined by IVUS (32 pts), the SCFph was always associated with hidden atherosclerosis, and a plaque burden of ≥33%. On the contrary, in the normal runoff group, any grade of PB was observed (from no athero to a PB > 70%) and remarkably, 10 pts had no signs of athero or just a minimal plaque burden. This resulted in a ROC curve analysis in which PB < 33% had a high negative predictive value (100%) in ruling out the SCFph. In addition, considering a CFR value < 2.21 as an index of coronary microcirculatory dysfunction, we found CMD in 15 pts (15%) in group 1 and in 7 pts (29%) in group 2 (p = ns). In conclusion, the SCFph is strongly connected to epicardial athero to the extent that the absence of hidden coronary athero has a very high negative predictive power in ruling out SCFph. CFR that is based on an endothelium-independent mechanism remains fairly normal in this condition. An endothelium-dependent microcirculatory constriction at rest due to atherosclerotic involvement of the coronary microvascular network is a possible explanation of the SCFph. Full article
(This article belongs to the Special Issue Coronary Heart Disease Imaging)
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