Diagnosis Of Coronary Artery Stenosis Research Articles

Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study

Ascending Aortic Stiffness Analysis Using Tissue Doppler Imaging for the Diagnosis of Coronary Artery Stenosis in Suspected Stable Angina: A Retrospective Study

The value of PMCTA in the diagnosis of coronary atherosclerosis in isolated human hearts.

The methods and parameters for coronary angiography in isolated human hearts were standardized based on the previous researcher.PMCTA in isolated human hearts is including the 3D reconstruction technique that reveals the coronary artery lesions more objectively and vividly, and provides the opportunity to re-read the data at anytime.PMCTA could only be used to examine the pathological changes of blood vessels, which might have limitations for the diagnosis of causes of death.PMCTA in isolated human hearts can be viewed as an auxiliary method for establishing the cause of death, which can provide an assessment of degree and extent of arterial stenosis and accurately help determine the abnormal location.

Diagnostic accuracy of coronary artery stenosis and thrombosis assessment using unenhanced multiplanar 3D post-mortem cardiac magnetic resonance imaging

BackgroundA 3D sequence was introduced to unenhanced post-mortem cardiac magnetic resonance imaging (PMCMR) to enable multiplanar coronary artery image analysis and to investigate its diagnostic accuracy for the diagnosis of coronary artery stenosis and thrombosis. Materials and MethodsN = 200 forensic cases with suspected coronary artery pathology underwent 3 Tesla PMCMR (sequence used: T2 weighted transversal 3D turbo spin echo) before autopsy. Main coronary artery stenosis and thrombosis were assessed in PMCMR by multiplanar image analysis by two observers. Coronary artery histology was determined as the gold standard and compared to PMCMR. Sensitivity, specificity, negative (NPV) and positive predictive values (PPV) with 95% confidence intervals were calculated. ResultsFor all coronary arteries combined, sensitivity was 75% (PPV 73%) for the diagnosis of stenosis and 72% (PPV 71%) for the diagnosis of thrombosis. Specificity was 92% (NPV 90%) for correct diagnosis of non-existing stenosis and 97% (NPV 97%) for non-existing thrombosis. Sensitivity for correct diagnosis of different degrees of stenosis ranged between 67% and 80% (PPVs 67–82%); specificity ranged between 96% and 99% (NPVs 96–99%). ConclusionMultiplanar PMCMR coronary artery stenosis and thrombosis assessment based on an unenhanced T2 weighted 3D sequence provide moderate sensitivity and high specificity for the diagnosis of coronary artery stenosis and/or thrombosis. Hence, 3D T2w PMCMR cannot reliably detect existing coronary artery stenosis and thrombosis but may be particularly useful for the exclusion of stenosis or thrombosis of the main coronary arteries.

Imaging Effect and Accuracy Analysis of 64-Slice Spiral CT in the Diagnosis of Coronary Artery Stenosis

Objective: To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary arterystenosis. Methods: 30 patients with suspected coronary heart disease admitted to our hospital from March 2022 to March 2023 were selected. All patients underwent both 64-slice spiral CT and digital subtraction angiography (DSA). DSA is considered the gold standard for diagnosis, so it was used to analyze the diagnostic performance of 64-slice spiral CT. Results: (1) The diagnostic results of digital subtraction angiography and 64-slice spiral CT was analyzed and compared with each other. The 64-slice spiral CT had an accuracy of 96.67% (29/30), a sensitivity 96.55% (28/29), and a specificity of 100.00% (1/1) in diagnosing coronary artery stenosis. (2) There was no significant difference between 64-slice spiral CT and digital subtraction angiography in the positive detection rate of anterior descending artery lesion, the positive detection rate of left main lesion, the positive detection rate of left circumflex artery lesion and the positive detection rate of right coronary artery lesion (P > 0.05). (3) There was no significant difference between 64-slice spiral CT examination and DSA examination in identifying mild stenosis, moderate stenosis, and severe stenosis of coronary arteries (P > 0.05). Conclusion: 64-slice spiral CT examination can accurately determine the degree of occlusion of coronary arteries, which allows for the accurate diagnosis of coronary artery stenosis.

Comparison of Clinical Diagnostic Value of 64-Slice Spiral CT Coronary Angiography and Coronary Angiography in the Diagnosis of Coronary Artery Stenosis

Comparison of Clinical Diagnostic Value of 64-Slice Spiral CT Coronary Angiography and Coronary Angiography in the Diagnosis of Coronary Artery Stenosis

The Value of CTA Based on Gold Nanorod Contrast Agent in Coronary Artery Diagnosis and Plaque Property Analysis.

Coronary CT angiography (CTA) with the characteristics of noninvasive and simple operation is widely used in the diagnosis of coronary artery stenosis. The choice of contrast agent exerts an important impact on the imaging quality of CTA. Conventional iodine contrast agents are easily excreted by the kidneys, from which the imaging window is short, and the imaging quality is poor. Metal nanomaterials have unique optical properties and have broad application prospects in imaging. Our aim is to explore the value of gold nanorod contrast agent in the diagnosis of coronary heart disease. A gold nanorod suspension was first prepared, and the prepared gold nanorod was uniform and had good dispersibility. It can be seen from the light absorption curve that there are two obvious peaks on the UV absorption peak of the gold nanorods. The gold nanorods were cultured in different solutions, and it was found that the particle size of the gold nanorods did not change significantly within 72 hours, indicating that the prepared gold nanorods had good stability. When observing the damage degree of mouse kidney tissue, it was shown that the damage degree of gold nanorod contrast agent to mouse kidney tissue was less than that of iodine contrast agent. The above results indicate that the gold nanorod contrast agent has good stability and safety. Therefore, our study demonstrated that the gold nanorod contrast agent has high value in the diagnosis of coronary arteries and the analysis of plaque properties.

Associations of Circulating microRNA-221 and 222 With the Severity of Coronary Artery Lesions in Acute Coronary Syndrome Patients

Circulating levels of microRNA-221 and 222 (miR-221/222) in patients with coronary artery disease (CAD) are elevated, yet the relationship between circulating miR-221/222 and the severity of coronary lesions in patients with acute coronary syndrome (ACS) remains unknown. In this study, the relative expression levels of circulating miR-221/222 in patients with ACS (n = 267) and controls (n = 71) were compared by real-time fluorescence quantitative-polymerase chain reaction (RT-qPCR). The ACS group was further divided into unstable angina pectoris (UA) group (n = 191) and acute myocardial infarction (AMI) group (n = 76). Significant upregulation of circulating miR-221/222 was observed in ACS. A positive linear correlation between circulating miR-221/222 and Gensini scores was demonstrated. The area under the curve (AUC) of circulating miR-221/222 in the diagnosis of coronary artery stenosis ≥50% was 0.605 and 0.643, respectively. The circulating miRNA-221/222 expression levels in ACS patients were elevated and positively associated with the severity of the coronary artery lesions. Circulating miR-221/222 may be novel biomarkers for the diagnosis of coronary artery stenosis ≥50% and the occurrence of ACS.

Comparison of LBM and FVM in the estimation of LAD stenosis.

The finite volume method (FVM)-based computational fluid dynamics (CFD) technology has been applied in the non-invasive diagnosis of coronary artery stenosis. Nonetheless, FVM is a time-consuming process. In addition to FVM, the lattice Boltzmann method (LBM) is used in fluid flow simulation. Unlike FVM solving the Navier-Stokes equations, LBM directly solves the simplified Boltzmann equation, thus saving computational time. In this study, 12 patients with left anterior descending (LAD) stenosis, diagnosed by CTA, are analysed using FVM and LBM. The velocities, pressures, and wall shear stress (WSS) predicted using FVM and LBM for each patient is compared. In particular, the ratio of the average and maximum speed at the stenotic part characterising the degree of stenosis is compared. Finally, the golden standard of LAD stenosis, invasive fractional flow reserve (FFR), is applied to justify the simulation results. Our results show that LBM and FVM are consistent in blood flow simulation. In the region with a high degree of stenosis, the local flow patterns in those two solvers are slightly different, resulting in minor differences in local WSS estimation and blood speed ratio estimation. Notably, these differences do not result in an inconsistent estimation. Comparison with invasive FFR shows that, in most cases, the non-invasive diagnosis is consistent with FFR measurements. However, in some cases, the non-invasive diagnosis either underestimates or overestimates the degree of stenosis. This deviation is caused by the difference between physiological and simulation conditions that remains the biggest challenge faced by all CFD-based non-invasive diagnostic methods.

P665 Role of 2-dimensional speckle tracking echocardiography in improving diagnosis of coronary artery stenosis in stable angina pectoris patients

Abstract Background conventional echocardiography at rest provides little information regarding the presence of CAD, Longitudinally orientated myocardial fibers are located subendocardially, the area most susceptible to ischaemia, that is why measurements of longitudinal motion and deformation may be the most sensitive markers of CAD using (2DSE) The aim of this study was to determine if 2DSE performed at rest can enhance the sensitivity of exercise test and if it can predict the presence of coronary artery disease in patients with stable angina pectoris. Methods our study included (120) subjects suspected to be stable angina pectoris patients presented for evaluation of chest pain at Al-Hussein University Hospital – Al-Azhar University – Cairo – Egypt between December 2013 and December 2015, The patients were classified according to coronary angiography results in to two groups: Group (A): 40 patients with normal coronary angiography as a control subjects,Group (B): 80 patients with significant coronary artery disease. Results There was statistically significant difference between the two groups as regard E wave, A wave, E/A ration, DT, Em and E/Em, there was statistically significant difference between the two groups as regard SLSS and GLS 17 and GLS 12, there was statistically significant difference between the two groups as regard SLSr and Sr17and Sr 12, there was statistically significant difference between the two groups as regard ST segment deviation during stress ECG, exercise capacity (METs) and Duke Score,;in this study we found that strain parameters at BA, BAS, MA, MIS, MAS, AI and AL segments were found to be significant predictor of LAD stenosis and BP and MP were found to be significant predictor of LCX stenosis and BI was found to be predictor of RCA stenosis, also we found that strain rate parameters at BA, MA, MAS, AI, AL and apex segments were found to be significant predictor of LAD stenosis, and BL, BP and ML were found to be significant predictor of LCX stenosis and BI and MI were found to be predictor of RCA stenosis, the diagnostic performance of the exercise test was significantly improved by GLS17 in terms of a significant increased AUC for the exercise test in combination with GLS17 Conclusion: In patients with suspected SAP, GLS assessed by 2DSE at rest is a predictor of significant CAD and significantly improves the diagnostic performance of exercise test, and capable of identifying which coronary artery is stenotic.

MP-PIC simulation of blood cell movement through a LAD with high stenosis

Computed Tomography Angiography (CTA)-based computational fluid dynamics (CFD) has been proposed as a non-invasive method for the diagnosis of coronary artery stenosis. Although blood contains a huge amount of blood cells, it is still treated as a single-phase fluid in most of the current CFD models. This may result in inaccurate estimations of the pressure drop through a stenotic artery. In this study, a multiphase particle in cell (MP-PIC) model that includes particle movement in fluid, was proposed to simulate the pressure drop through coronary artery stenosis. A male patient with high stenosis at his left anterior descending (LAD) was chosen as a patient-specific model. Both conventional single-phase model and MP-PIC were used to simulate the pressure drop at this patient-specific model. Specifically, two types of spherical particles were used in MP-PIC to represent the non-spherical red blood cells. Particle 1 has the equivalent volume while particle 2 has the equivalent surface area of a red blood cell. The comparison of simulation results and clinical invasive measurement showed that the single-phase fluid model greatly underestimated the pressure drop; the predicted pressure drop is 6 mm Hg while the measured pressure drop is 20 mm Hg. Particle model 1 also underestimated the pressure drop (15 mm Hg) while particle model 2 overestimated the pressured drop (25 mm Hg). This study indicated that accurate estimation of pressure drop through artery stenosis requires reasonable multiphase models.

Automatic multi-region segmentation of intracoronary optical coherence tomography images based on neutrosophic theory

Optical coherence tomography (OCT) has become a key technique in the diagnosis of coronary artery stenosis, which can identify plaques and vulnerable plaques in the image. Therefore, this technique is of great significance for the diagnosis of coronary heart disease. However, there is still a lack of automatic, multi-region, high-precision segmentation algorithms for coronary OCT images in the current research field. Therefore, this paper proposes a multi-zone, fully automated segmentation algorithm for coronary OCT images based on neutrosophic theory, which achieves high-precision segmentation of fibrous plaques and lipid regions. In this paper, the method of transforming OCT images into T in the area of neutrosophics is redefined based on the membership function, and the segmentation accuracy of fiber plaques is improved. For the segmentation of lipid regions, the algorithm adds homomorphic filter enhancement images, and uses OCT to transform OCT images into I in the field of neutrosophics, and further uses morphological methods to achieve high-precision segmentation. In this paper, 40 OCT images from 9 patients with typical plaques were analyzed and compared with the results of manual segmentation by doctors. Experiments show that the proposed algorithm avoids the over-segmentation and under-segmentation problems of the traditional neutrosophic theory method, and accurately segment the patch area. Therefore, the work of this paper can effectively improve the accuracy of segmentation of plaque for doctors, and assist clinicians in the diagnosis and treatment of coronary heart disease.

P556Left ventricular 4D Strain during dobutamine stress echocardiography for diagnosis of coronary artery stenosis in patients with intermediate pretest probability of coronary artery disease

P556Left ventricular 4D Strain during dobutamine stress echocardiography for diagnosis of coronary artery stenosis in patients with intermediate pretest probability of coronary artery disease

The contrast research between left ventricular three dimensional strain and coronary angiography for coronary disease patients without segmental ventricular wall motion abnormalities

Objective To evaluate the left ventricular diastolic function in coronary artery disease(CAD) patients without regional wall motion abnormality by real-time three-dimensional specke tracking imaging(RT3D-STI), and to investigate the value of RT3D-STI in detecting CAD. Methods According on coronary angiography, 92 patients without regional wall motion abnormality were divided into two groups: control group(n=21), without coronary artery stenosis; case group(n=50), coronary stenosis group. Two dimensional images and the three-dimensional full volume dynamic images of left ventricle were collected. Routine parameters and end-systolic left ventricular globle longitudinal strain(GLS), globle circumferential strain (GCS), globle area strain (GAS), globle radial strain (GRS) and corresponding strain imaging diastolic index (SI-DI) were aquired, respectively. The parameters by RT3D-STI were analyzed to diagnose coronary artery stenosis. Results Compared with control group, there were no significant difference in routine parameters, GLS, GRS, GAS and GCS(P>0.05). Longitudinal SI-DI(L-SI-DI), area SI-DI(A-SI-DI), radial SI-DI(R-SI-DI), circumferential SI-DI(C-SI-DI) in case group were significantly reduced compared with control group (P<0.05). The sensitivity of L-SI-DI, A-SI-DI, R-SI-DI and C-SI-DI were 90.5%, 81.0%, 85.7%, 81.0%, and the specificity of them were 82.0%, 78.0%, 68%, 56%, respectively, L-SI-DI was the best in sensitivity and specificity. L-SI-DI, A-SI-DI, R-SI-DI were significantly correlated with Gensini score(r= -0.706, -0.547, -0.410 P<0.05). Conclusions RT3D-STI can quantitatively assess the early changes of left ventricular diastolic function, which has important significance for early diagnosis of coronary artery stenosis. Key words: Echocardiography, real-time three-dimensional; Coronary disease; Ventricular function, left; Speckle tracking imaging

The diagnostic evaluation of 640 slice computed tomography angiography in the diagnosis of coronary artery stenosis

ABSTRACT Objective: The aim was to evaluate diagnostic accuracy of 640 slice computed tomography angiography (640-CTCA) in diagnosis of coronary artery stenosis. Materials and Methods: Selective coronary angiography (SCA) and 640 slice CTCA were performed in 120 patients with suspected coronary artery disease (CAD) (78 male, 42 female, aged from 36 to 79 years old, with an average of 58.23 years). Various post-processing reconstructions of coronary arteries and branches, such as volumetric imaging, multi-planar reconstruction, curved planar reconstruction, maximum intensity projection were used. The coronary segments, with statistical evaluations combined with its diameter ≥1.5 mm were collected to analyze the diagnosis accuracy of 640-CTCA on coronary artery stenosis, with SCA as the reference standard. Results: About 96.91% (1535/1584) of coronary artery segments were evaluable arteries, and the sensitivity, specificity, positive and negative predictive value of 640-CTCA for detecting coronary artery stenosis were 93.44%, 99.59%, 95.00% and 99.45% respectively. 3.09% (49/1584) of coronary artery segments could not be evaluated due to motion artifact in 21 segments, calcification in 18 segments and poor display of lumen in 10 segments. There were no significant differences in the diagnostic accuracy of coronary artery stenosis between 640-CTCA and SCA. Conclusion: 640-CTCA has a higher accuracy and specificity, which is a reliable tool in the screening of CAD, coronary surgery, preoperative evaluation and the postoperative follow-up.

A Semi-Automatic Coronary Artery Segmentation Framework Using Mechanical Simulation.

CVD (cardiovascular disease) is one of the biggest threats to human beings nowadays. An early and quantitative diagnosis of CVD is important in extending lifespan and improving people's life quality. Coronary artery stenosis can prevent CVD. To diagnose the degree of stenosis, the inner diameter of coronary artery needs to be measured. To achieve such measurement, the coronary artery is segmented by using a method that is based on morphology and the continuity between computed tomography image slices. A centerline extraction method based on mechanical simulation is proposed. This centerline extraction method can figure out a basic framework of the coronary artery by simulating pixel dots of the artery image into mass points. Such mass points have tensile forces, with which the outer pixel dots can be drawn to the center. Subsequently, the centerline of the coronary artery can be outlined by using the local line-fitting method. Finally, the nearest point method is adopted to measure the inner diameter. Experimental results showed that the methods proposed in this paper can precisely extract the centerline of the coronary artery and can accurately measure its inner diameter, thereby providing a basis for quantitative diagnosis of coronary artery stenosis.

Comparison of Myocardial Transmural Perfusion Gradient by Magnetic Resonance Imaging to Fractional Flow Reserve in Patients With Suspected Coronary Artery Disease

The goal of this study was to evaluate the diagnostic accuracy of transmural perfusion gradient (TPG) and transmural perfusion gradient reserve (TPGR) with 3.0 T cardiac magnetic resonance (CMR) against invasively determined fractional flow reserve (FFR) to detect coronary artery stenosis. Quantitative analysis of myocardial perfusion with CMR to diagnosis coronary artery disease (CAD) has been widely accepted. However, traditional transmural myocardial perfusion analysis with CMR neglects that endocardium is more vulnerable to ischemia than epicardium. TPG and TPGR can take the inhomogenous perfusion impairment into account and be more sensitive and specific for diagnosis of CAD. In this study, 71 patients (57 men, age 60.1 ± 6.4 years) with known or suspected CAD referred for invasive angiography study underwent rest and adenosine-induced stress CMR perfusion imaging scan. FFR was attempted to be measured in all major epicardial coronary arteries. FFR ≤0.75 was regarded to indicate a hemodynamic significant coronary lesion. A TPG ≤0.85 predicted significant CAD with sensitivity and specificity of 74.55% and 83.65%, respectively. Sensitivity and specificity of TPGR ≤0.81 were 90.91% and 89.94%, respectively. Area under the receiver-operating curve to detect FFR ≤0.75 was 0.86 for TPG and 0.95 for TPGR. TPGR yielded significantly better sensitivity and specificity for diagnosis of CAD than traditional myocardial blood flow, myocardial perfusion reserve, and TPG (p < 0.0001). In conclusion, TPG and TPGR analyses with MRI are capable of detecting hemodynamic stenosis of coronary artery and superior to traditional myocardial perfusion analysis. Furthermore, TPGR appears to be superior to TPG in the diagnosis of coronary artery stenosis.

A simple framework to generate 3D patient-specific model of coronary artery bifurcation from single-plane angiographic images

Although computer-based simulations, such as structural finite element analysis, have proven their usefulness to support procedural planning of coronary stenting, the link between the clinical practice and these engineering techniques is still limited to research test-cases. A key point to further promote such an interaction is to generate in a fast and effective manner the computational grids from the medical images. Hence, the present study proposes a simple framework to generate 3D meshes of coronary bifurcations from a pair of planar angiographic images obtained by X-ray angiography, which is the gold standard technique for the diagnosis of coronary artery stenosis.

The clinical value of 64-slice CT angiography in the diagnosis of coronary artery stenosis

Objective To discuss the clinical value of 64-slice CT angiography in the diagnosis of coronary artery stenosis.Methods 60 patients with suspected coronary artery disease were examined by CAG and 64SCT,then we contrasted the results,and diagnostic value of 64SCT in coronary artery stenosis was tested by CAG as the gold standard.Results The number of coronary section could clearly show in 64SCT(458) were significantly more than in the CAG(504)(x2 =20.1318,P＜0.01) ;but there was no significant difference in the diagnosis rates of coronary heart disease between the two methods (P ＞0.05) ;the sensitivity of 64SCT in coronary artery disease was 93.4％,specificity 96.0％,positive predictive value of 88.0％,and negative predictive value of 97.9％.Conclusion Compared with CAG deficiencies in the diagnosis of coronary artery stenosis,64SCT has higher value.,and it has high sensitivity,specificity,positive and negative predictive value in the diagnosis of coronary artery stenosis,and which is worthy of early screening for the disease. Key words: Coronary Stenosis; Coronary angiography ; Tomography, X-ray computed

A miniature fiber optic blood pressure sensor and its application in in vivo blood pressure measurements of a swine model

Fractional flow reserve (FFR) is a promising technique in diagnosis of coronary artery stenosis. The technique is applied in coronary catheterization to measure the blood pressure (BP) difference across a coronary artery stenosis in the blood flow. In vivo BP measurement is the key element in FFR diagnosis. This paper describes the utilizing of a novel miniature fiber optic sensor to measure the BP of a swine model in vivo. A 25–50kg Yorkshire swine model was used as the test target. A guiding catheter was introduced into the coronary artery, and blood pressure signals in aortic arch and right coronary artery were measured by the fiber optic sensor. A standard invasive manometry was used as the reference. Finally, a 2.25mm balloon was inflated in the catheter to simulate the stenosis and the BP drop was recorded by the fiber optic sensor. The experiment demonstrates that the reported fiber optic sensor has the capability of measuring blood pressure in vivo and can be used for FFR technique.

Tissue Doppler echocardiography improves the diagnosis of coronary artery stenosis in stable angina pectoris

Aim To determine if colour tissue Doppler imaging (TDI) performed at rest in patients with suspected stable angina pectoris (SAP) is able to predict the presence of significant coronary artery disease (CAD). This study comprises 296 consecutive patients with clinically suspected SAP, no previous cardiac history, and a normal ejection fraction. All patients were examined by colour TDI, exercise electrocardiogram (ECG), and coronary angiography (CAG). Regional longitudinal systolic (s'), early diastolic (e'), and late diastolic (a') myocardial velocities were measured by colour TDI at six mitral annular sites and averaged to provide global estimates. Duke score (DS), including ST depression, chest pain, and exercise capacity, was used as the outcome of the exercise ECG. Patients with an area stenosis of ≥70% in at least one epicardial coronary artery were categorized as having a significant CAD (n= 108) and were compared with patients without significant CAD (n= 188). Both e' [odds ratio (OR): 1.5 (1.1-1.9, P < 0.01) per cm/s decrease] and s' [OR: 1.7 (1.1-2.5, P < 0.05) per cm/s decrease] remained independent predictors of CAD after multivariable adjustment for baseline, exercise ECG, and conventional echocardiographic parameters. Area under the receiver operating characteristic curve (AUC) for exercise ECG and TDI in combination was significantly higher than AUC for exercise ECG alone (0.84 vs. 0.79, P < 0.01). In patients with suspected SAP colour TDI performed at rest is an independent predictor of significant CAD, and colour TDI improves the diagnostic performance of exercise ECG.