Abstract
Accurate coronary measurements are important in guiding percutaneous coronary intervention. Intravascular ultrasound is a widely accepted diagnostic modality for coronary measurement before percutaneous coronary intervention. The spatial resolution of optical coherence tomography is 10 times larger than that of intravascular ultrasound. The objective of the study was to compare quantitative and qualitative parameters of frequency domain optical coherence tomography (FDOCT) with those of intravascular ultrasound and coronary angiography in patients with acute myocardial infarction. Diagnostic parameters of coronary angiography, intravascular ultrasound, and FDOCT of 250 patients with coronary artery disease who required admission diagnosis were included in the analyses. Minimum lumen diameter detected by FDOCT was larger than that detected by quantitative coronary angiography (2.11±0.1 vs 1.89±0.09 mm, P<0.0001, q=34.67) but smaller than that detected by intravascular ultrasound (2.11±0.1 vs 2.19±0.11 mm, P<0.0001, q=12.61). Minimum lumen area detected by FDOCT was smaller than that detected by intravascular ultrasound (3.41±0.01 vs 3.69±0.01 mm2, P<0.0001). FDOCT detected higher numbers of thrombus, tissue protrusion, dissection, and incomplete stent apposition than those detected by intravascular ultrasound (P<0.0001 for all). More accurate and sensitive results of the coronary lumen can be detected by FDOCT than coronary angiography and intravascular ultrasound (level of evidence: III).
Highlights
Atherosclerosis is the leading cause of myocardial infarction [1], morbidity, and mortality [2] in the Chinese population
The data regarding quantitative coronary angiography, intravascular ultrasound, and Frequencydomain optical coherence tomography (FDOCT) of these patients were not included in the analysis
Quantitative measurements Minimum lumen diameter detected by FDOCT was larger than that detected by quantitative coronary angiography (2.11±0.1 vs 1.89±0.09 mm, Po0.0001, q=34.67) but smaller than that detected by intravascular ultrasound (2.11±0.1 vs 2.19±0.11 mm, Po0.0001, q=12.61, Figure 2)
Summary
Atherosclerosis is the leading cause of myocardial infarction [1], morbidity, and mortality [2] in the Chinese population. Intravascular ultrasound is a widely accepted diagnostic modality in cases of myocardial infarction because it provides moving images, has no risk of radiation dose, is economical, detects atherosclerosis, and quantifies plaque geometry and structure [5] but it is an invasive method and requires experienced cardiologists for interpretation of images [6]. It is used in a low proportion of percutaneous coronary interventions where gross analysis is possible [6]. Frequencydomain optical coherence tomography (FDOCT) provides 100 frames/s for imaging of long vessels, which is feasible for diagnosis of coronary plaque [7] but the accuracy and sensitivity of FDOCT are not completely clear [4]
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