Drug-coated balloon angioplasty (DCBA) has been recognized for its utility in preventing in-stent re-restenosis (ISR); however, imaging of the neointima immediately after treatment and during ...follow-up has only been described in a few case reports. This study aimed to determine the efficacy and mechanism of the DCBA using imaging studies both immediately after the DCBA and during the follow-up period. We enrolled 15 consecutive patients who underwent DCBA for in-stent restenosis (ISR). The in-stent neointimal volume was evaluated using optical coherence tomography (OCT), and the in-stent yellow grade was assessed using coronary angioscopy (CAS) immediately after DCBA and during the median follow-up period of 9 (8–15) months. The neointimal volume was significantly reduced from 77.1 ± 36.2 mm
3
at baseline to 60.2 ± 23.9 mm
3
immediately after DCBA (
p
= 0.0012 vs. baseline) and to 46.7 ± 21.9 mm
3
during the follow-up (
p
= 0.0002 vs. post DCBA). The yellow grade of the residual plaques at the ISR lesion, which indicated plaque vulnerability, was significantly decreased in the follow-up CAG (from baseline: 1.79 ± 1.03, during the follow-up: 0.76 ± 0.82;
p
< 0.0001). These data suggest that DCBA may inhibit neointimal formation and provide angioscopic intimal stabilization for ISR lesions.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background
The possibility of permanent cardiovascular damage causing cardiovascular long COVID has been suggested; however, data are insufficient. This study investigated the prevalence of ...cardiovascular disorders, particularly in patients with cardiovascular long COVID using multi-modality imaging.
Methods
A total of 584 patients admitted to the hospital due to COVID-19 between January 2020 and September 2021 were initially considered. Upon outpatient follow-up, 52 (9%) were suspected to have cardiovascular long COVID, had complaints of chest pain, dyspnea, or palpitations, and were finally enrolled in this study. This study is registered with the Japanese University Hospital Medical Information Network (UMIN 000047978).
Results
Of 52 patients with long COVID who were followed up in the outpatient clinic for cardiovascular symptoms, cardiovascular disorders were present in 27% (14/52). Among them, 15% (8/52) had myocardial injury, 8% (4/52) pulmonary embolisms, and 4% (2/52) both. The incidence of a severe condition (36% 5/14 vs. 8% 3/38,
p
= 0.014) and in-hospital cardiac events (71% 10/14 vs. 24% 9/38,
p
= 0.002) was significantly higher in patients with cardiovascular disorders than in those without. A multivariate logistic regression analysis revealed that a severe condition (OR, 5.789; 95% CI 1.442–45.220;
p
= 0.017) and in-hospital cardiac events (OR, 8.079; 95% CI 1.306–25.657;
p
= 0.021) were independent risk factors of cardiovascular disorders in cardiovascular long COVID patients.
Conclusions
Suspicion of cardiovascular involvement in patients with cardiovascular long COVID in this study was approximately 30%. A severe condition during hospitalization and in-hospital cardiac events were risk factors of a cardiovascular sequalae in CV long COVID patients.
Aims: Wall shear stress (WSS) has been considered a major determinant of aortic atherosclerosis. Recently, non-obstructive general angioscopy (NOGA) was developed to visualize various atherosclerotic ...pathologies, including in vivo ruptured plaque (RP) in the aorta. However, the relationship between aortic RP and WSS distribution within the aortic wall is unclear. This study aimed to investigate the relationship between aortic NOGA-derived RP and the stereographic distribution of WSS by computational fluid dynamics (CFD) modeling using three-dimensional computed tomography (3D-CT) angiography. Methods: We investigated 45 consecutive patients who underwent 3D-CT before coronary angiography and NOGA during coronary angiography. WSS in the aortic arch was measured by CFD analysis based on the finite element method using uniform inlet and outlet flow conditions. Aortic RP was detected by NOGA. Results: Patients with a distinct RP showed a significantly higher maximum WSS value in the aortic arch than those without aortic RP (56.2+-30.6 Pa vs 36.2+-19.8 Pa, p=0.017), no significant difference was noted in the mean WSS between those with and without aortic RP. In a multivariate logistic regression analysis, the presence of a maximum WSS value more than a specific value was a significant predictor of aortic RP (odds ratio 7.21, 95% confidence interval 1.78-37.1, p=0.005). Conclusions: Aortic RP detected by NOGA was strongly associated with a higher maximum WSS in the aortic arch derived by CFD using 3D-CT. The maximum WSS value may have an important role in the underlying mechanism of not only aortic atherosclerosis, but also aortic RP.
Allergic reactions to iodine contrast agent rarely lead to anaphylactic shock affecting hemodynamics. We treated two cases of anaphylactic shock during coronary angiography, which did not respond to ...adrenaline because thepatients had taken beta-blockers. Instead, glucagon relieved their conditions. If patients treated with beta-blockersexperience anaphylactic shock during coronary angiography, we should consider glucagon as a treatment optionbecause the persistence of shock refractory to adrenaline leads to unfavorable outcomes.
Abstract only
Background:
Although atherosclerotic disease including myocardial infarction had decreased with lipid-lowering therapy for LDL cholesterol, atherosclerotic risk factors as residual ...risks without low-density lipoprotein are pointed out. Especially, lipoprotein (a) had been reported as one of the cardiovascular risks. Non-obstructive general angioscopy (NOGA) can meticulously visualize directly aortic atherosclerosis. NOGA-derived aortic vulnerable plaques had been reported to be related to future cardiovascular events. However, the relationships between serum lipoprotein (a) value and NOGA-derived aortic plaques had not been fully investigated yet.
Methods and Results:
We investigated consecutive 165 cases with coronary artery disease evaluated for the aorta by NOGA. Atherosclerotic lesions of the aorta were screened using NOGA immediately after coronary arteriography. NOGA examination evaluated the presence of aortic ruptured plaques which were "puff-chandelier rupture" appearance as previously reported. The mean age was 68 years and the median lipoprotein (a) value was 16 9-27. The median number of plaque ruptures was 1 0-3, and 60% of cases had at least one plaque rupture. In a logistic regression analysis for the presence of aortic plaque rupture, the serum lipoprotein (a) value was associated with NOGA-derived aortic plaque rupture (odds ratio, 1.01 1.0-1.03, p < 0.05). The study patients were divided into three groups according to the tertile of serum lipoprotein (a) value 1st tertile: 0-11 mg/dl, 2nd tertile: 12-24 mg/dl, 3rd tertile 25 mg/dl <, the first tertile had the lowest prevalence of plaque rupture (the presence of plaque rupture: first tertile 50%, second tertile 71%, third tertile 72%, p = 0.03).
Conclusion:
Serum lipoprotein (a) value was related to the presence of the aortic plaque rupture. Further studies are needed to elucidate the effect of the low lipoprotein (a) on the prevention of aortic vulnerable plaques.
The diagnosis of acute myocardial infarctions (MIs) is challenging when no significant ischemic ST-segment changes are noted on a 12-lead electrocardiogram (ECG). We herein report two patients ...suffering from chest pain in whom non-gated enhanced computed tomography (CT) images were used to rule out aortic dissection and pulmonary embolism, aiding in the early diagnosis of an acute MI. Subsequently, urgent revascularization was successfully performed in these patients. In non-gated enhanced CT imaging, the infarcted myocardium is initially visible as a focal myocardial perfusion defect.
Abstract only Introduction: It remains unclear how systemic atherosclerosis can affect ocular microvessels. The abnormality of the ocular microvasculatures can be non-invasively detected by measuring ...ocular arterial blood flow velocity using laser speckle flowgraphy (LSFG). Among the ocular blood flow parameters obtained by LFSG, the ocular blowout time (BOT) and the ocular resistivity index (RI) are used as the index of retinal vascular resistance. The purpose of this study was to investigate the relationship between ocular vascular resistance evaluated by LSFG and cardiac function evaluated by transthoracic echocardiography in patients with acute coronary syndrome (ACS). Methods: We evaluated 53 patients with ACS who were taken to Coronary Care Unit between April 2019 and September 2020. The mean blur rate (MBR), the ocular blowout time (BOT) and the ocular resistivity index (RI) were measured by LSFG. In addition, the age-matched normal subjects were also evaluated the measurement of LSFG in 20 healthy subjects with no ocular disease and no history of cardiovascular disease. Results: Among all ACS patients, there were significant positive correlations between ocular RI and systemic parameters, i.e., IMT(r = 0.34, P = 0.01), PWV(r = 0.41, P < 0.01), BUN(r = 0.27, P = 0.047), cystatin C(r = 0.32, P = 0.020), urinary β2 microglobulin(r = 0.30, P = 0.029), L-FABP(r = 0.28, P = 0.046), and E/e’(r = 0.34, P = 0.013). There was also significant negative correlation between ocular BOT and PWV(r = -0.44, P < 0.01). Age-matched comparing the selective ACS (n=20) with healthy group (n=20), the ocular RI was significantly higher in the ACS group (0.34 ± 0.04 vs 0.38 ± 0.07, P = 0.03). Conclusions: We found that the ocular resistivity index, which was non-invasively obtained by LSFG, was associated with systemic atherosclerosis, early renal dysfunction and cardiac diastolic dysfunction in ACS patients, suggesting that it might be useful index as an non-invasive comprehensive arteriosclerotic markers.
Abstract only
Introduction:
Periaortic adipose tissue (PAAT) is related to the development of cardiovascular disease. However, the relationship between periaortic adipose tissue (PAAT) and aortic ...plaque instability has not been elucidated.
Hypothesis:
We hypothesized that PAAT would be associated with aortic vulnerable plaques derived non-obstructive general angioscopy (NOGA) in patients with cardiovascular disease.
Methods:
We investigated 117 patients who underwent NOGA of the aorta and CT. PAAT volume was measured using the volume-rendering method by extracting the area from -30 to -190 HU within the thoracic aorta. PAAT volume index (PAAT-I) was defined as PAAT volume divided by the body surface area. We evaluated the number of vulnerable plaques including ruptured plaques, ulcerations, thrombi, intense yellow plaques by NOGA in the whole aorta. All patients were divided into the median value of PAAT-I (16.9 13.0 - 21.6 ml/m2)
Results:
The high PAAT-I patients had significantly greater number of vulnerable plaques in the thoracic aorta than the low PAAT-I patients (2 1-4 vs 1 0-3, p<0.05). The PAAT-I had a correlation with the number of vulnerable plaques in the thoracic and whole aorta (r=0.44, p<0.001, r=0.35, p<0.01, respectively)
Conclusions:
PAAT in the thoracic aorta was related to the number of NOGA derived-aortic vulnerable plaques in patients with cardiovascular disease. PAAT may play an important role in the development of aortic plaque instability.
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