Publications by authors named "Tsai Tsung-Ying"

Background: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS) improves outcomes compared with angiography-guided PCI, however cardiac events still occur during long-term follow-up of FFR-negative patients. In the PREVENT study preventive PCI reduced cardiac-events in lesions which were FFR-negative (FFR > 0.80) and had intracoronary imaging defined vulnerable plaque.

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Traditionally, coronary angiography was restricted to visual estimation of contrast-filled lumen in coronary obstructive diseases. Over the previous decades, considerable development has been made in quantitatively analyzing coronary angiography, significantly improving its accuracy and reproducibility.  Notably, the integration of artificial intelligence (AI) and machine learning into quantitative coronary angiography (QCA) holds promise for further enhancing diagnostic accuracy and predictive capabilities.

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  • The LANDMARK trial compared the balloon-expandable Myval transcatheter heart valve (THV) series to the SAPIEN and Evolut THV series in 768 patients to evaluate safety and effectiveness.
  • Results showed that Myval achieved non-inferiority to SAPIEN (24.7% vs 24.1%) and Evolut (24.7% vs 30.0%) regarding a primary composite safety endpoint.
  • Additionally, while Myval had better pressure gradient metrics compared to SAPIEN, Evolut showed slightly higher rates of prosthetic valve regurgitation compared to Myval but no significant difference between Myval and SAPIEN.
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Polarization-entangled photons are indispensable to numerous quantum technologies and fundamental studies. In this paper, we propose and demonstrate what we believe to be a novel source that generates collinear polarization-entangled photons by simultaneously achieving two distinct types of phase-matching conditions (noncritically birefringent and quasi phase matching) in a periodically poled nonlinear crystal with a large poling period of 2 mm. The photon pairs are generated in a polarization-entangled state with a fidelity and concurrence of 0.

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  • - The ACC/AHA Chest Pain guidelines support the use of Coronary CT Angiography (CCTA) and FFRCT for better diagnosing coronary artery disease (CAD), yet many healthcare providers are not following these recommendations.
  • - In a study involving 673 stable chest pain patients across five European countries, CCTA emerged as the most frequently used noninvasive test, but nearly 40% of patients still received immediate CAD treatment without prior testing.
  • - The study revealed a lack of progress in improving adherence to CCTA and a low usage of FFRCT, underscoring the need for better diagnostic practices and updates to reimbursement policies.
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  • This study investigates how to predict suboptimal quantitative flow ratios (QFR) after successful PCI, as current models are lacking in this area.
  • The researchers created a nomogram using data from 450 vessels to evaluate the prediction based on five key variables, including a new metric called QFR-PPG.
  • Results showed strong predictive performance with high accuracy in different validation tests, highlighting the nomogram's potential to aid clinicians in making informed decisions post-PCI.
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  • Coronary microvascular dysfunction (CMD) often occurs after ST-elevation myocardial infarction (STEMI) and can negatively impact patient outcomes; TMAO, a gut microbiota metabolite, may help diagnose CMD in these patients.
  • In a study involving 210 STEMI patients, TMAO levels were measured at various points, with a key finding being that TMAO at 3 months was a more reliable indicator for diagnosing CMD compared to baseline levels.
  • The research concluded that high TMAO levels (≥3.91) were linked to a greater risk of major adverse cardiovascular and cerebrovascular events (MACCE), highlighting TMAO's potential as a biomarker that could enhance
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Background: JenaValve's Trilogy transcatheter heart valve (THV) (JenaValve Inc, Irvine, CA) is the only -marked THV system for the treatment of aortic regurgitation (AR) or aortic stenosis (AS). However, its efficacy has not been quantitatively investigated pre- and post-implantation using video-densitometric analysis.

Methods: Using the CAAS-A-Valve 2.

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Background: Paravalvular regurgitation (PVR) is a common complication after transcatheter aortic valve replacement, posing an increased risk of heart failure and mortality. Accurate intraprocedural quantification of PVR is challenging. Both hemodynamic indices and videodensitometry can be used for intraprocedural assessment of PVR.

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Introduction: The higher scaffold thrombosis rates observed with the first-generation bioresorbable scaffolds (BRSs) compared to conventional drug-eluting stents were likely due in part to bioresorbable polymers having insufficient radial strength, necessitating larger strut profiles. Meta-analysis of the long-term outcomes from the first-generation Absorb bioresorbable vascular scaffold (BVS) showed that this period of excess risk ended at 3 years. Therefore, current attention has been focused on improving early outcomes by increasing the scaffold's tensile strength and reducing strut thickness.

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  • The study examines the ratio of coronary artery lumen volume (V) to myocardial mass (M) to understand the relationship between coronary arteries and heart muscle in patients with complex coronary artery disease (CAD) prior to surgery.
  • It analyzes data from coronary computed tomography angiography (CCTA) in participants from a specific trial (FAST-TRACK CABG) and compares results with another patient cohort (ADVANCE registry).
  • Findings indicate that patients requiring coronary artery bypass grafting (CABG) had significantly lower V/M ratios than those in the ADVANCE registry, suggesting that V/M could serve as a useful non-invasive marker for assessing CAD severity, particularly alongside fractional flow reserve (FFR) measurements.
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Background: There are different definitions of periprocedural myocardial infarction (PPMI) both in terms of thresholds for cardiac biomarkers and the ancillary criteria for myocardial ischemia. Cardiac Troponin I (cTnI) and cardiac Troponin T (cTnT) are used interchangeably to diagnose PPMI.

Objectives: This study evaluated the frequency of periprocedural myocardial injury and infarction as defined by the Society of Cardiovascular Angiography & Interventions (SCAI), the Academic Research Consortium-2 (ARC-2), and the 4th Universal definition of MI (4UDMI) stratified using cTnT versus cTnI, among patients with chronic coronary syndrome (CCS) and unstable angina.

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  • * A case was reported where this condition was accidentally found after the surgery, specifically linked to aorta cross-clamping.
  • * The dissection was effectively managed through careful monitoring, using advanced 3D holographic and fluid dynamics analysis to guide treatment decisions.
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Background: Microvascular resistance reserve (MRR) can characterize coronary microvascular dysfunction (CMD); however, its prognostic impact in ST-segment elevation myocardial infarction (STEMI) patients remains undefined.

Objectives: This study sought to investigate the prevalence of CMD in STEMI patients and to elucidate the prognostic performance of MRR.

Methods: This prospective cohort study enrolled 210 STEMI patients with multivessel disease who underwent successful revascularization and returned at 3 months for coronary physiology assessments with bolus thermodilution.

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Introduction: The baseline characteristics affecting mortality following percutaneous or surgical revascularization in patients with left main and / or 3‑vessel coronary artery disease (CAD) observed in real‑world practice differ from those established in randomized controlled trials (RCTs) due to the constraints of inclusion / exclusion criteria.

Objectives: This study aimed to assess whether systematic screening enables identification of novel and registry‑specific baseline patient characteristics influencing long‑term mortality.

Patient And Methods: Least absolute shrinkage and selection operator (LASSO) regression was used to screen 42 baseline patient characteristics shared by the SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) trial and a single‑center Polish registry of 1035 consecutive patients with complex CAD who received revascularization and were followed-up for 5 years.

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  • The study aimed to determine if quantitative features from coronary computed tomography angiography (CCTA) can help distinguish total occlusions (TOs) from severe stenoses observed during invasive coronary angiography (ICA).
  • A total of 84 TOs were identified in a sample of 114 patients, showing a 56% agreement rate in diagnosis between CCTA and ICA, with TOs having a greater average lesion length compared to severe stenoses.
  • The key finding indicated that a lesion length greater than 5.5 mm is a strong predictor for differentiating between TOs and severe stenoses, with notable differences in calcium and fibro-fatty atheroma volumes as well.
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Background: Coronary microvascular dysfunction (CMD) is a common complication of ST-segment-elevation myocardial infarction (STEMI) and can lead to adverse cardiovascular events. Whether CMD after STEMI is associated with functional left ventricular remodeling (FLVR) and diastolic dysfunction, has not been investigated.

Methods And Results: This is a nonrandomized, observational, prospective study of patients with STEMI with multivessel disease.

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Article Synopsis
  • In patients with complex coronary artery disease, selecting a revascularization strategy using coronary computed tomography angiography (CCTA) shows high agreement with invasive coronary angiography (ICA) results.
  • The study involved planning coronary artery bypass grafting (CABG) based on CCTA alone, achieving a high feasibility rate of 99.1% and strong agreement between the CCTA team and actual treatment decisions.
  • Follow-up results indicated a 92.6% graft patency rate after 30 days, with low rates of major adverse cardiac events (7.2%) and major bleeding (2.7%), supporting the safety of this approach.
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Myocardial perfusion imaging (MPI) is a clinical tool which can assess the heart's perfusion status, thereby revealing impairments in patients' cardiac function. Within the MPI modality, the acquired three-dimensional signals are typically represented as a sequence of two-dimensional grayscale tomographic images. Here, we proposed an end-to-end survival training approach for processing gray-scale MPI tomograms to generate a risk score which reflects subsequent time to cardiovascular incidents, including cardiovascular death, non-fatal myocardial infarction, and non-fatal ischemic stroke (collectively known as Major Adverse Cardiovascular Events; MACE) as well as Congestive Heart Failure (CHF).

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Introduction: The levels of low-density lipoprotein (LDL) cholesterol in plasma are important risk factors for coronary heart disease. Several reports suggest that elevated plasma cholesterol is associated with cardiac arrhythmias. In a subsequent study investigating LDL cholesterol levels and the frequency of LDL cholesterol measurements, a positive correlation was observed between the severity of sleep apnea and visit-to-visit LDL cholesterol variability.

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  • The study investigates the geographical differences in coronary artery disease (CAD) characteristics among patients from Japan and Brazil, focusing on those undergoing percutaneous coronary intervention (PCI).
  • Results show that Japanese patients had more significant functional stenoses and lower post-PCI flow ratios compared to Brazilian patients, indicating a disparity in CAD patterns between the two regions.
  • The findings suggest that assessing both pre-procedural physiological indices and the diffuseness of CAD can help identify patients who may benefit most from PCI, highlighting the importance of tailored treatment approaches.
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  • Mixed reality (MR) holograms can effectively display 3D images while allowing users to remain aware of their surroundings, offering a new method for measuring coronary artery bypass grafts using gestures and voice commands.
  • A study involving follow-up CT scans of 30 patients demonstrated that holographic measurements were feasible in 97.1% of cases, with high accuracy and excellent agreement between hologram and CT measurements.
  • The findings suggest that this real-time holographic measurement approach is quick and reliable, potentially enhancing clinical decision-making by enabling doctors to visualize and measure grafts directly.
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