Development and Validation of Artificial Intelligence-Based Algorithms for Predicting the Segments Debulked by Rotational Atherectomy Using Intravascular Ultrasound Images.

We develop and evaluate an artificial intelligence (AI)-based algorithm that uses pre-rotation atherectomy (RA) intravascular ultrasound (IVUS) images to automatically predict regions debulked by RA. A total of 2106 IVUS cross-sections from 60 patients with de novo severely calcified coronary lesions who underwent IVUS-guided RA were consecutively collected. The 2 identical IVUS images of pre- and post-RA were merged, and the orientations of the debulked segments identified in the merged images were marked on the outer circle of each IVUS image.

Isomerization and epimerization of fructose in phosphate buffer under subcritical water conditions.

Isomerization and epimerization of fructose to glucose, mannose, allulose, and allose were executed using a subcritical phosphate buffer solution to effectively produce useful monosaccharides. The conversion of the substrate and the yield of products were dependent on the reaction temperature, initial pH, initial substrate concentration, and buffer concentration. A high yield of mannose was achieved under the optimal reaction conditions we identified.

Frequency and Distribution of Sheet and Nodular Calcification in Coronary Arteries in Japanese Patients.

Whether a nodular calcification (NC), which is the precursor to intracoronary thrombosis, is focally or diffusely distributed in the coronary tree has major implications for ongoing efforts to identify. This study aimed to investigate the frequency and spatial distribution patterns of sheet calcification (SC) and NC in a 3-vessel examination of autopsied human hearts.A total of 323 coronary artery specimens from 110 cadavers were obtained from autopsy cases.

Prediction of medial damage by rotational atherectomy using intravascular ultrasound.

Objective: This study evaluated whether intravascular ultrasound (IVUS) images before rotational atherectomy (RA) can predict medial injury caused by RA burr passage in advance.

Methods: Thirty-three patients with de-novo lesions located in the left anterior descending coronary artery (LAD) who underwent IVUS before and immediately after RA were enrolled. The spatial axes of the two matched pre- and post-RA IVUS cross-sectional images were merged.

Diagnostic Accuracy of Optical Frequency Domain Imaging for Identifying Necrotic Cores with Intraplaque Hemorrhage in Advanced Human Carotid Plaques.

This study investigated whether optical frequency domain imaging (OFDI) can identify carotid artery vulnerable plaque characteristics, focusing on lipid-rich necrotic core (NC) and intraplaque hemorrhage (IPH). Fourteen patients scheduled for carotid endarterectomy underwent OFDI scan during preoperative angiography. Atherosclerotic plaque specimens obtained from carotid endarterectomy were cut every 3-4 mm into 4-μm transverse cross-sections and stained with standard methods.

Automated classification of coronary atherosclerotic plaque in optical frequency domain imaging based on deep learning.

Background And Aims: We developed a deep learning (DL) model for automated atherosclerotic plaque categorization using optical frequency domain imaging (OFDI) and performed quantitative and visual evaluations.

Methods: A total of 1103 histological cross-sections from 45 autopsy hearts were examined to compare the ex vivo OFDI scans. The images were segmented and annotated considering four histological categories: pathological intimal thickening (PIT), fibrous cap atheroma (FA), fibrocalcific plaque (FC), and healed erosion/rupture (HER).

Additional decrease in fractional flow reserve in the left anterior descending artery after hand-grip exercise during pharmacological coronary hyperemia.

Maximal hyperemia at the time of fractional flow reserve (FFR) measurement is generally induced by vasodilators, even when hyperemia at the onset of angina symptoms is caused by exercise stress. This study was designed to evaluate whether pharmacological hyperemia could be used as a substitute for exercise-induced hyperemia during FFR measurement. Twenty-two patients with angiographically intermediate stenosis in the left anterior descending artery (LAD) were prospectively enrolled.

The incidence, natural history, and predictive factors for tissue protrusion after drug-eluting stent implantation.

Objectives And Background: Although tissue protrusion (TP) between the stent struts after stent implantation has been implicate as a potential factor of stent failure, the incidence, natural history, and predictive factor of TP after stent implantation remains unclear. This prospective study evaluated the fate of TP after drug-eluting stent (DES) deployment using optical coherence tomography (OCT).

Method And Result: This study analyzed TP for 42 lesions after DES in which three serial OCTs, including preprocedure, postprocedure, and 1-month after the procedure were performed.

Influence of different physiological hemodynamics on fractional flow reserve values in the left coronary artery and right coronary artery.

Background: Although the left coronary artery (LCA) has a flow profile in that most blood flow occurs during diastole rather than systole, the right coronary artery (RCA) has a flow pattern that is less diastolic dominant. This study assessed whether coronary pressure waveforms distal to stenoses with the same fractional flow reserve (FFR) was the same between the LCA and RCA.

Methods: A total of 347 vessels from 318 patients who underwent FFR measurements were included.

Diagnostic accuracy of optical coherence tomography for the identification of in-stent fibroatheroma following stent implantation: an ex vivo histological validation study.

The accurate identification of in-stent fibroatheroma by in vivo imaging is clinically important to preventing the late catch-up phenomenon after stent deployment. This study investigated the diagnostic accuracy of optical coherence tomography (OCT) for the detection of "in-stent fibroatheroma" following stent implantation. Fifty stented coronary arteries from the 31 autopsy hearts were examined to compare OCT and histological image findings.

Interobserver variability in assessments of atherosclerotic lesion type via optical frequency domain imaging.

Background: To date, there have been no data available regarding the diagnostic performance of optical frequency domain imaging (OFDI) for in vivo histological classification of atherosclerotic lesions. This study investigated whether OFDI can be used to diagnose and classify histological atherosclerotic lesions in the coronary artery by ex vivo histological examinations.

Methods: Three-hundred-fifteen histological cross-sections from 21 autopsy hearts were matched with the OFDI images.

Prediction of optimal debulking segments before rotational atherectomy based on pre-procedural intravascular ultrasound findings.

This study evaluated whether intravascular ultrasound (IVUS) examination before rotational atherectomy (RA) can predict the optimal route of passage of the RA burr along the vessel. 30 patients with calcified lesions who underwent IVUS before and immediately after RA were enrolled. IVUS analyses were performed at the minimum lumen area (MLA) site and at 0.

Prognostic Value of Psoas Muscle Mass Index in Patients With Non‒ST-Segment‒Elevation Myocardial Infarction: A Prospective Observational Study.

Background Muscle wasting is an important predictor of long-term outcome in patients with cardiovascular disease, but the prognostic value of muscle wasting in patients with non‒ST-segment‒elevation myocardial infarction is not established. The aim of this study is to investigate the prognostic value of muscle wasting, defined by psoas muscle mass index (PMI), in patients with non‒ST-segment‒elevation myocardial infarction. Methods and Results A total of 132 consecutive patients with non‒ST-segment‒elevation myocardial infarction were prospectively enrolled between 2015 and 2018.

Loss of skeletal muscle mass predicts cardiac death in heart failure with a preserved ejection fraction but not heart failure with a reduced ejection fraction.

Aims: Loss of skeletal muscle mass is an important determinant associated with poor long-term prognosis in patients with acute decompensated heart failure (ADHF). However, limited evidence is available. This study investigated the prognostic value of the psoas muscle mass index (PMI) in patients with ADHF.

Tangential signal dropout artefact in optical frequency domain imaging.

Background: Tangential signal dropout (TSD), which occurs when the optical frequency domain imaging (OFDI) beam strikes the vessel wall under a glancing angle and travels almost parallel to the vessel wall, is the most important imaging artefact leading to the erroneous diagnosis of lipid-rich plaques.

Aims: This study aimed to evaluate the OFDI artefact of TSD, which mimics the appearance of lipid-rich plaque and macrophage (Mø) infiltration.

Methods: A total of 1,019 histological cross-sections from 23 autopsy hearts were matched with the corresponding OFDI images.

Coronary artery calcification as a novel predictive marker of unstable coronary lesion in survivors of out-of-hospital cardiac arrest without ST-segment elevation.

Aim: Acute myocardial infarction (AMI) is the leading cause of out-of-hospital cardiac arrest (OHCA). A highly predictive marker is needed to identify AMI in survivors of OHCA without ST-segment elevation because the appropriate indication for emergency coronary artery angiography in patients without ST-segment segment elevation has not been determined. Accordingly, the aim of this study was to elucidate the clinical significance of coronary artery calcification in identifying survivors of OHCA without ST-segment elevation who could benefit from emergency coronary artery angiography.