Non-Invasive Assessment of Coronary Microvascular Dysfunction Using Vascular Deformation-Based Flow Estimation.

Objective: Non-invasive computation of the index of microcirculatory resistance from coronary computed tomography angiography (CTA), referred to as IMR[Formula: see text], is a promising approach for quantitative assessment of coronary microvascular dysfunction (CMD). However, the computation of IMR[Formula: see text] remains an important unresolved problem due to its high requirement for the accuracy of coronary blood flow. Existing CTA-based methods for estimating coronary blood flow rely on physiological assumption models to indirectly identify, which leads to inadequate personalization of total and vessel-specific flow.

Distraction-aware hierarchical learning for vascular structure segmentation in intravascular ultrasound images.

Vascular structure segmentation in intravascular ultrasound (IVUS) images plays an important role in pre-procedural evaluation of percutaneous coronary intervention (PCI). However, vascular structure segmentation in IVUS images has the challenge of structure-dependent distractions. Structure-dependent distractions are categorized into two cases, structural intrinsic distractions and inter-structural distractions.

Validation of a new non-hyperemic physiological index: the constant-resistance ratio (cRR).

Objectives: The instantaneous wave-free ratio (iwFR) has limited availability. A new resting index called the constant-resistance ratio (cRR), which dynamically identifies cardiac intervals with constant and minimum resistance, has been developed; however, its diagnostic performance is unknown. The aim of this study was to validate the cRR by retrospectively calculating the cRR values from raw pressure waveforms of 2 publicly available datasets and compare them with those of the iwFR.

A novel de-escalation antiplatelet therapy for patients with acute coronary syndrome undergoing percutaneous coronary intervention.

To investigate the effect of different DAPTs in patients with ACS undergoing PCI, and to identify the most efficient DAPT to reduce the risk of ischemia and bleeding after PCI. Between March 2017 and December 2021, 1598 patients with ACS who underwent PCI were included in the study. The DAPT protocol included the clopidogrel group (aspirin 100 mg + clopidogrel 75 mg), ticagrelor group (aspirin 100 mg + ticagrelor 90 mg), de-escalation Group 1 (reduced dose of ticagrelor [from 90 mg to 60 mg]) after 3 months of oral DAPT [aspirin 100 mg + ticagrelor 90 mg]), and de-escalation Group 2 (switched from ticagrelor to clopidogrel after 3 months of oral DAPT [aspirin 100 mg + ticagrelor 90 mg]).

Vessel Contour Detection in Intracoronary Images via Bilateral Cross-Domain Adaptation.

Vessel contour detection (VCD) in intravascular images is important for the quantitative assessment of vessels. However, it is still a challenging task due to a high degree of morphology variability. Images from a single modality lack sufficient information on the vessel morphology due to the natural limitation of the imaging capability.

Scale Mutualized Perception for Vessel Border Detection in Intravascular Ultrasound Images.

Vessel border detection in IVUS images is essential for coronary disease diagnosis. It helps to obtain the clinical indices on the inner vessel morphology to indicate the stenosis. However, the existing methods suffer the challenge of scale-dependent interference.

Progressive Perception Learning for Main Coronary Segmentation in X-Ray Angiography.

Main coronary segmentation from the X-ray angiography images is important for the computer-aided diagnosis and treatment of coronary disease. However, it confronts the challenge at three different image granularities (the semantic, surrounding, and local levels). The challenge includes the semantic confusion between the main and collateral vessels, low contrast between the foreground vessel and background surroundings, and local ambiguity near the vessel boundaries.

The clinical impact of serum 1,5-anhydro-D-glucitol levels on coronary artery calcification and adverse outcomes assessed by coronary optical coherence tomography in diabetic patients.

Background: Serum 1,5-anhydro-D-glucitol (1,5-AG) is a novel biomarker for short-term glycemic status and postprandial hyperglycemia. The association between serum 1,5-AG levels and coronary artery calcification (CAC) through a quantitative assessment using optical coherence tomography (OCT) is unclear. We aimed to evaluate this association using OCT in patients with diabetes mellitus (DM).

Deep learning-based automated left ventricular ejection fraction assessment using 2-D echocardiography.

Deep learning (DL) has been applied for automatic left ventricle (LV) ejection fraction (EF) measurement, but the diagnostic performance was rarely evaluated for various phenotypes of heart disease. This study aims to evaluate a new DL algorithm for automated LVEF measurement using two-dimensional echocardiography (2DE) images collected from three centers. The impact of three ultrasound machines and three phenotypes of heart diseases on the automatic LVEF measurement was evaluated.

Multicenter clinical evaluation of a piezoresistive-MEMS-sensor rapid-exchange pressure microcatheter system for fractional flow reserve measurement.

Objectives: This multicenter, prospective clinical study investigates whether the microelectromechanical-systems-(MEMS)-sensor pressure microcatheter (MEMS-PMC) is comparable to a conventional pressure wire in fractional flow reserve (FFR) measurement.

Background: As a conventional tool for FFR measurement, pressure wires (PWs) still have some limitations such as suboptimal handling characteristics and unable to maintain the wire position during pullback assessment. Recently, a MEMS-PMC compatible with any 0.

A 2-year investigation of the impact of the computed tomography-derived fractional flow reserve calculated using a deep learning algorithm on routine decision-making for coronary artery disease management.

Objective: This study aims to investigate the safety and feasibility of using a deep learning algorithm to calculate computed tomography angiography-based fractional flow reserve (DL-FFRCT) as an alternative to invasive coronary angiography (ICA) in the selection of patients for coronary intervention.

Materials And Methods: Patients (N = 296) with symptomatic coronary artery disease identified by coronary computed tomography angiography (CTA) with stenosis over 50% were retrospectively enrolled from a single centre in this study. ICA-guided interventions were performed in patients at admission, and DL-FFRCT was conducted retrospectively.

The Serum Metabolic Biomarkers in Early Diagnosis and Risk Stratification of Acute Coronary Syndrome.

Despite advances in the treatment of coronary diseases, acute coronary syndrome (ACS) remains the leading cause of death worldwide. ACS is associated with metabolic abnormalities of lipid oxidation stress. In this study, based on liquid chromatograph mass spectrometry technique, we conducted the metabolic profiling analysis of serum samples from stable plaques (SPs) and vulnerable plaques (VPs) in ACS patients for exploring the potential biomarkers of plaque stability.

Privileged Modality Distillation for Vessel Border Detection in Intracoronary Imaging.

Intracoronary imaging is a crucial imaging technology in coronary disease diagnosis as it visualizes the internal tissue morphologies of coronary arteries. Vessel border detection in intracoronary images (VBDI) is desired because it can help the succeeding procedures of computer-aided disease diagnosis. However, existing VDBI methods suffer from the challenge of vessel-environment variability (i.

Association between asymmetric dimethylarginine and in-stent restenosis tissue characteristics assessed by optical coherence tomography.

Background: Impaired bioavailability of endothelium-derived nitric oxide (NO) and endothelial dysfunction may play a pivotal role in the pathogenesis of in-stent restenosis (ISR) after coronary stenting. We aimed to investigate the relation between asymmetric dimethylarginine (ADMA), an endogenous NO synthase inhibitor, and the ISR lesions tissue characteristics assessed by optical coherence tomography (OCT).

Methods And Results: Forty-five patients with symptomatic ISR lesions (17 bare metal stents, 28 drug-eluting stents, medium implantation duration: 58.

Evaluation of fractional flow reserve in patients with stable angina: can CT compete with angiography?

Background: We aimed to compare the performance of FFR and FFR in assessing the functional significance of coronary artery stenosis in patients suffering from coronary artery disease with stable angina.

Method: A total of 101 stable coronary heart disease (CAD) patients with 181 lesions were recruited. FFR and FFR were compared using invasive fractional flow reserve (FFR) as a reference standard.

Analysis of beat-to-beat blood pressure variability response to the cold pressor test in the offspring of hypertensive and normotensive parents.

Abnormal autonomic nervous regulation has an important role in the development of hypertension. As to whether blood pressure (BP) or BP variability represents the proper characteristics for predisposition to hypertension in Chinese young adults remains controversial. We studied the properties of the indices extracted from beat-to-beat BP during a 13 min cold pressor test (CPT).

An artificial neural network method for lumen and media-adventitia border detection in IVUS.

Intravascular ultrasound (IVUS) has been well recognized as one powerful imaging technique to evaluate the stenosis inside the coronary arteries. The detection of lumen border and media-adventitia (MA) border in IVUS images is the key procedure to determine the plaque burden inside the coronary arteries, but this detection could be burdensome to the doctor because of large volume of the IVUS images. In this paper, we use the artificial neural network (ANN) method as the feature learning algorithm for the detection of the lumen and MA borders in IVUS images.

Efficacy of an early home-based cardiac rehabilitation program for patients after acute myocardial infarction: A three-dimensional speckle tracking echocardiography randomized trial.

Background: The effect of an early short-term home-based cardiac rehabilitation (CR) program on ventricular function in acute myocardial infarction (AMI) patients is not yet clear. The purpose of this study was to evaluate the efficacy of our CR program on the improvement of myocardial function using three-dimensional speckle tracking echocardiography (3D-STE) in AMI patients.

Methods: Fifty-two AMI patients were randomly assigned to 2 groups after discharge: the rehabilitation group, which participated in an early, home-based CR program, and the control group, which received only usual care.

Three-dimensional hemodynamics analysis of the circle of Willis in the patient-specific nonintegral arterial structures.

The hemodynamic alteration in the cerebral circulation caused by the geometric variations in the cerebral circulation arterial network of the circle of Wills (CoW) can lead to fatal ischemic attacks in the brain. The geometric variations due to impairment in the arterial network result in incomplete cerebral arterial structure of CoW and inadequate blood supply to the brain. Therefore, it is of great importance to understand the hemodynamics of the CoW, for efficiently and precisely evaluating the status of blood supply to the brain.

High-speed intravascular spectroscopic photoacoustic imaging at 1000 A-lines per second with a 0.9-mm diameter catheter.

Intravascular spectroscopic photoacoustic technology can image atherosclerotic plaque composition with high sensitivity and specificity, which is critical for identifying vulnerable plaques. Here, we designed and engineered a catheter of 0.9 mm in diameter for intravascular photoacoustic (IVPA) imaging, smaller than the critical size of 1 mm required for clinical translation.

Automated Framework for Detecting Lumen and Media-Adventitia Borders in Intravascular Ultrasound Images.

An automated framework for detecting lumen and media-adventitia borders in intravascular ultrasound images was developed on the basis of an adaptive region-growing method and an unsupervised clustering method. To demonstrate the capability of the framework, linear regression, Bland-Altman analysis and distance analysis were used to quantitatively investigate the correlation, agreement and spatial distance, respectively, between our detected borders and manually traced borders in 337 intravascular ultrasound images in vivo acquired from six patients. The results of these investigations revealed good correlation (r = 0.

Automated detection framework of the calcified plaque with acoustic shadowing in IVUS images.

Intravascular Ultrasound (IVUS) is one ultrasonic imaging technology to acquire vascular cross-sectional images for the visualization of the inner vessel structure. This technique has been widely used for the diagnosis and treatment of coronary artery diseases. The detection of the calcified plaque with acoustic shadowing in IVUS images plays a vital role in the quantitative analysis of atheromatous plaques.