Fractal analysis of dynamic, four-dimensional computed tomography myocardial perfusion (4D-CTP) imaging might have potential for noninvasive differentiation of microvascular ischemia and macrovascular coronary artery disease (CAD) using fractal dimension (FD) as quantitative parameter for perfusion complexity. This multi-center proof-of-concept study included 30 rigorously characterized patients from the AMPLIFiED trial with nonoverlapping and confirmed microvascular ischemia (n = 10), macrovascular CAD (n = 10), or normal myocardial perfusion (n = 10) with invasive coronary angiography and fractional flow reserve (FFR) measurements as reference standard. Perfusion complexity was comparatively high in normal perfusion (FD = 4.49, interquartile range [IQR]:4.46-4.53), moderately reduced in microvascular ischemia (FD = 4.37, IQR:4.36-4.37), and strongly reduced in macrovascular CAD (FD = 4.26, IQR:4.24-4.27), which allowed to differentiate both ischemia types, p < 0.001. Fractal analysis agreed excellently with perfusion state (κ = 0.96, AUC = 0.98), whereas myocardial blood flow (MBF) showed moderate agreement (κ = 0.77, AUC = 0.78). For detecting CAD patients, fractal analysis outperformed MBF estimation with sensitivity and specificity of 100% and 85% versus 100% and 25%, p = 0.02. In conclusion, fractal analysis of 4D-CTP allows to differentiate microvascular from macrovascular ischemia and improves detection of hemodynamically significant CAD in comparison to MBF estimation.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948301 | PMC |
| http://dx.doi.org/10.1038/s41598-022-09144-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of different glycoprotein IIb/IIIa inhibitor infusion routes on infarct size and microvascular obstruction in patients with high thrombotic risk ST elevation myocardial infarction.
Acta Cardiol
January 2025
Division of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Objective: Current guidelines recommend the use of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibitors in patients with ST-segment elevation myocardial infarction (STEMI) only as a bail-out therapy. However, drug penetration to the jeopardised area may not be achieved due to impeded blood flow and increased microvascular resistance. Aim of our study is to investigate the impact of distal intracoronary GpIIb/IIIa inhibitor agent infusion in STEMI patients.
View Article and Find Full Text PDFDecreased Choriocapillaris Vessel Density in the Ipsilateral Eye after Carotid Artery Revascularization Detected by Widefield Swept-Source OCT Angiography.
Ophthalmol Sci
November 2024
Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, China.
Objective: To investigate the short-term blood flow changes and image features of the retina and choroid in patients who underwent carotid artery revascularization (CAR) for severe carotid artery stenosis using widefield swept-source OCT angiography (OCTA).
Design: Prospective study.
Participants: This prospective study included 112 eyes (56 eyes on the ipsilateral side and 56 eyes on the contralateral side) of 56 participants with severe carotid artery stenosis.
Unveiling the interplay between soluble guanylate cyclase activation and redox signalling in stroke pathophysiology and treatment.
Biomed Pharmacother
January 2025
Department of Neurology and Center for Translational Neuro, and Behavioural Sciences (C-TNBS), Department of Neurology, University Hospital Essen, Essen 45147, Germany; Department of Pharmacology & Personalised Medicine, MeHNS, Faculty of Health, Medicine & Life Science, Maastricht University, Maastricht, ER 6229, the Netherlands. Electronic address:
Soluble guanylate cyclase (sGC) stands as a pivotal regulatory element in intracellular signalling pathways, mediating the formation of cyclic guanosine monophosphate (cGMP) and impacting diverse physiological processes across tissues. Increased formation of reactive oxygen species (ROS) is widely recognized to modulate cGMP signalling. Indeed, oxidatively damaged, and therefore inactive sGC, contributes to poor vascular reactivity and more severe neurological damage upon stroke.
View Article and Find Full Text PDFIschemia during exercise stress testing, an indication of coronary vasomotor dysfunction?
Int J Cardiol Heart Vasc
February 2025
Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
Background: Recently it has been suggested that coronary microvascular dysfunction (CMD) may explain the high false-positive rate of exercise electrocardiographic stress testing (EST). However, patients with angina but non-obstructive coronary artery disease (ANOCA) present with a broader spectrum of coronary vasomotor dysfunction (CVDys), namely coronary artery spasm (CAS), CMD or a combination of both. We aim to investigate the diagnostic value of EST for the entire CVDys spectrum.
View Article and Find Full Text PDFFocusing on microvascular function in heart failure with preserved ejection fraction.
Heart Fail Rev
January 2025
Department of Cardiology, Cardiology I, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
Heart failure is a prevalent global health issue. Heart failure with preserved ejection fraction (HFpEF), which already represents half of all heart cases worldwide, is projected to further increase, driven by aging populations and rising cardiovascular risk factors. Effective therapies for HFpEF remain limited, particularly due to its pathophysiological heterogeneity and incomplete understanding of underlying pathomechanisms and implications.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!