Publications by authors named "Kai Nogami"
Background: Limited research has explored the prognostic significance of changes in coronary flow velocity reserve (CFVR), as measured by stress-transthoracic Doppler echocardiography (S-TDE), following elective percutaneous coronary intervention (PCI). This study aimed to assess whether post-PCI changes in CFVR are associated with major adverse cardiac events (MACE) and to identify baseline clinical factors that predict improvement of CFVR.
Methods: A retrospective analysis was performed on 184 patients who underwent elective FFR-guided PCI for the left anterior descending (LAD) artery.
Objective: Epicardial stenosis and coronary microvascular dysfunction (CMD) may coexist in patients with chronic coronary syndrome (CCS). Microvascular resistance reserve (MRR) has been demonstrated to be a valid cross-modality metric using continuous saline infusion thermodilution and intracoronary Doppler flow velocity methods. This study aimed to investigate the prevalence and diagnostic concordance of CMD defined by MRR using two methods-stress transthoracic Doppler echocardiography (S-TDE) and the invasive bolus thermodilution method (B-Thermo)-in patients with functionally significant epicardial stenosis.
View Article and Find Full Text PDFBackground: Global coronary flow reserve (G-CFR) impairment represents coronary microvascular dysfunction (CMD) and correlates with poor prognosis. Hyperemic coronary flow is reduced in conventional CMD, but normal or mildly reduced with elevated resting flow in endogenous-type CMD (E-CMD). This retrospective study assessed the prognostic value of post-percutaneous coronary intervention (PCI) CMD, focusing on E-CMD.
View Article and Find Full Text PDFCoronary flow capacity (CFC) integrates quantitative assessment of hyperemic myocardial blood flow and coronary flow reserve. We aimed to evaluate the effect of elective percutaneous coronary revascularization (PCI) on CFC using serial stress transthoracic Doppler echocardiography (STDE). Overall, 148 stable patients underwent STDE of the left anterior descending arteries (LAD), before and after elective PCI.
View Article and Find Full Text PDFBackground: Impaired global coronary flow reserve (G-CFR), evaluated through phase-contrast cine cardiovascular magnetic resonance (PC-CMR), has been linked to worse outcomes in patients with cardiovascular disease. This study aimed to investigate the prognostic value of G-CFR improvement, as evaluated using PC-CMR imaging pre- and post-percutaneous coronary intervention (PCI).
Methods: In this single-center study, 320 patients with chronic coronary syndrome (CCS) who underwent pre- and post-PCI PC-CMR measurements were followed up to determine major adverse cardiac or cerebrovascular events (MACCE) predictors.
Background: Stress-transthoracic Doppler echocardiography (S-TDE) provides a noninvasive assessment of coronary flow parameters in the left anterior descending artery (LAD). However, the association between morphological characteristics and coronary flow changes after elective percutaneous coronary intervention (PCI) remains unclear. We aimed to evaluate the relationships between periprocedural coronary flow changes observed on S-TDE and lesion-specific plaque characteristics obtained by optical coherence tomography (OCT) in the interrogated vessels in patients with chronic coronary syndrome (CCS).
View Article and Find Full Text PDFObjective: Unrecognized myocardial infarction (UMI) on delayed-enhancement cardiac magnetic resonance imaging (DE-CMR) and coronary computed tomography angiography (CCTA) derived high-risk features provide prognostic information in patients with chronic coronary syndrome (CCS). The study aimed to assess the prognostic value of UMI and predictors of UMI using CCTA in patients with CCS who underwent elective percutaneous coronary intervention (PCI).
Methods: This study enrolled 181 patients with CCS who underwent DE-CMR and CCTA before elective PCI.
This study investigated the prognostic value of cardiovascular magnetic resonance (CMR)-derived global coronary flow reserve (G-CFR) in addition to cardiopulmonary exercise testing (CPET) variables in patients with acute myocardial infarction (AMI). We investigated 127 patients with AMI who underwent primary or urgent percutaneous coronary intervention (PCI) and post-intervention CMR and CPET. The incidence of major cardiac and cerebrovascular events (MACCE), defined as all-cause death, recurrent non-fatal myocardial infarction, re-hospitalization due to congestive heart failure, and stroke, was evaluated (median follow-up, 2.
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- Recent studies indicate that calcified nodules (CN) in patients with acute coronary syndrome (ACS) are linked to worse health outcomes.
- The study involved 695 ACS patients and found that those with OCT-defined CN were typically older and had higher incidences of diabetes, hemodialysis, and severe heart failure compared to those without CN.
- Key predictors for the presence of OCT-CN included age, hemodialysis, and Killip Class III/IV heart failure, suggesting that these factors could indicate increased lesion severity and poorer prognosis for ACS patients.
Background: Myocardial bridge (MB) is a common coronary anomaly characterized by a tunneled course through the myocardium. Coronary computed tomography angiography (CCTA) can identify MB. The impact of MB detected by CCTA on coronary physiological parameters before and after percutaneous coronary intervention (PCI) is unknown.
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- The study investigates the relationship between two methods for assessing coronary flow reserve (CFR) before and after elective percutaneous coronary intervention (PCI) in patients with left anterior descending artery lesions.
- The analysis included 174 patients, revealing that while there is a modest correlation between pre-PCI CFR measurements from different techniques, post-PCI measurements showed no correlation.
- The findings indicate that these two CFR assessment methods provide distinct insights into coronary function, especially after PCI, implying they should not be used interchangeably.
Background: Coronary flow velocity reserve (CFVR) can be measured noninvasively using stress transthoracic Doppler echocardiography (S-TDE). The prognostic significance of S-TDE-derived CFVR after percutaneous coronary intervention (PCI) remains unknown. The aim of this study was to investigate the prognostic value of post-PCI CFVR and its additional efficacy to fractional flow reserve (FFR) in patients undergoing elective PCI.
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- A study investigated the effectiveness of computed tomography myocardial perfusion (CT-MP) in identifying coronary microvascular dysfunction (CMD) in patients with significant epicardial artery blockages.
- The research involved 68 patients with chronic coronary syndrome, comparing various heart flow metrics and plaque characteristics between those with and without CMD.
- Findings indicated that patients with CMD had lower hyperemic myocardial blood flow and a higher prevalence of compromised coronary flow reserve compared to those without CMD, suggesting differences in microvascular health despite similar fractional flow reserve values.
Article Synopsis
- A study was conducted to assess how effective preprocedural transthoracic echocardiography (TTE) is in detecting unrecognized myocardial infarction (UMI) in patients undergoing percutaneous coronary intervention (PCI).
- Researchers analyzed 138 patients with chronic coronary syndrome who had no prior heart attacks or surgeries, using late gadolinium enhancement cardiac MRI (CMR) to identify UMI.
- Results showed that TTE, along with two-dimensional speckle-tracking echocardiography (2D-STE), can successfully reveal UMI in patients, even when traditional ECG outcomes are normal.
Article Synopsis
- A study assessed the prognostic value of post-PCI fractional flow reserve (FFR) and coronary flow reserve (CFR) in predicting target vessel failure (TVF) after coronary interventions.
- The analysis included 466 patients with chronic coronary syndrome and demonstrated that 42.5% had discordant FFR and CFR results; 10.3% experienced TVF.
- Optimal cutoff values for predicting TVF were found to be FFR ≤0.85 and CFR <2.26, both of which independently indicated increased risk for TVF after the procedure.
Prognostic utility of the pericoronary fat attenuation index in patients with takotsubo cardiomyopathy.
J Cardiovasc Comput Tomogr
December 2023
Background: The etiology of takotsubo cardiomyopathy (TCM) remains poorly understood and no optimal management strategy has been established. Identification of features associated with poor outcomes may improve the prognosis of patients with TCM. We aimed to identify the predictors of poor prognosis in patients with TCM using coronary computed tomography angiography (CCTA).
View Article and Find Full Text PDFThis study sought to evaluate the prognostic implications of the presence of preprocedural unrecognized myocardial infarction (UMI) and periprocedural myocardial injury (PMI) evaluated by delayed gadolinium enhancement cardiac magnetic resonance (DE-CMR) in patients with chronic coronary syndrome (CCS) undergoing elective percutaneous coronary intervention (PCI). We enrolled 250 CCS patients scheduled for elective PCI. UMI was defined as the presence of late gadolinium enhancement (LGE) detected by pre-PCI CMR in the region without medical history of revascularization and/or MI.
View Article and Find Full Text PDFPurpose: Unrecognized myocardial infarction (UMI) detected by cardiac magnetic resonance (CMR) imaging is associated with adverse outcomes in patients with acute and chronic coronary syndrome. This study aimed to assess the predictors of optical coherence tomography (OCT) and coronary computed tomography angiography (CCTA) findings for non-infarct-related (non-IR) territory UMI in patients presenting with non-ST-elevation acute coronary syndrome (NSTE-ACS).
Methods: We investigated 69 patients with a first clinical episode of NSTE-ACS who underwent pre-percutaneous coronary intervention (PCI) 320-slice CCTA, uncomplicated urgent PCI with OCT assessment within 24 h of admission, and post-PCI CMR.
Background: Prognostic value of non-infarct-related territory (non-IR) unrecognized myocardial infarction (UMI) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) remains to be elucidated. We sought to evaluate the prognostic impact of non-IR UMI in patients with first NSTE-ACS presentation.
Methods: This retrospective single-center analysis was conducted in patients with NSTE-ACS without prior history of coronary artery disease, who underwent uncomplicated urgent percutaneous coronary intervention (PCI) within 48 h of admission between August 2014 and January 2018.
Background: The relationship of layered plaque detected by optical coherence tomography (OCT) with coronary inflammation and coronary flow reserve (CFR) remains elusive. We aimed to investigate the association of OCT-defined layered plaque with pericoronary adipose tissue (PCAT) inflammation assessed by coronary computed tomography angiography (CCTA) and global (G)-CFR assessed by cardiac magnetic resonance imaging (CMR) in patients with acute coronary syndrome (ACS).
Methods: We retrospectively investigated 88 patients with first ACS who underwent preprocedural CCTA, OCT imaging of the culprit lesion prior to primary/urgent percutaneous coronary intervention (PCI), and postprocedural CMR.
Article Synopsis
- A previous study struggled to differentiate between intact fibrous cap (IFC) and ruptured fibrous cap (RFC) lesions in patients with coronary artery disease, prompting this study to assess the effectiveness of coronary CT imaging before procedures for acute myocardial infarction.
- In analyzing 186 patients, researchers found that various CT markers were significantly lower in the IFC group, which helped highlight critical differences in plaque characteristics between IFC and RFC lesions.
- The study concluded that preprocedural coronary CT imaging can reliably distinguish between IFC and RFC lesions, helping to identify higher-risk patients non-invasively.
In the presence of functionally significant epicardial lesions, microvascular resistance reserve (MRR) calculation needs incorporation of collateral flow. Coronary fractional flow reserve (FFR ) requiring coronary wedge pressure (P ), which is an essential part of the true MRR calculation, is reportedly estimated by myocardial FFR (FFR ) not requiring P measurement. We sought to find an equation to calculate MRR without the need for P .
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