Assessment of Coronary Artery Distensibility by Intravascular Ultrasound

Nakatani, Satoshi; Yamagishi, Masakazu; Tamai, Jun; Goto, Yoichi; Umeno, Takatoshi; Kawaguchi, Akito; Yutani, Chikao; Miyatake, Kunio

doi:10.1161/01.cir.91.12.2904

Cited by 92 publications

(39 citation statements)

References 33 publications

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“…Atherosclerosis also has been implicated in the alteration of the pulsatile characteristics of blood vessels. 39,40 However, the relation between altered mechanical properties of blood vessels and atherosclerosis is complex and probably involves both structural and functional influences that have led to conflicting reports in the literature. 41 An attractive hypothesis consistent with the data are that altered endothelial function is at the root of the large and small artery compliance reduction with aging.…”

Section: Figurementioning

confidence: 99%

Age-Related Abnormalities in Arterial Compliance Identified by Pressure Pulse Contour Analysis

et al. 1999

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Abstract-The objective of this study was to evaluate age-related changes in pulsatile arterial function. Aging alters arterial pulsatile function and produces consistent changes in the pressure pulse contour. A reduced systemic arterial compliance that can be derived from analysis of the pulse contour is regarded as the best clinical index of impaired pulsatile arterial function and may mark the presence of early vascular damage. We analyzed intra-arterial brachial artery waveforms in 115 healthy normotensive volunteers (83 men, 32 women) and radial artery waveforms obtained with the use of a calibrated tonometer device in 212 healthy volunteers (147 women, 65 men). A computer-based assessment of the diastolic pressure decay and a modified Windkessel model of the circulation were used to quantify changes in arterial waveform morphology in terms of large artery or capacitive compliance, oscillatory or reflective compliance in the small arteries, inertance, and systemic vascular resistance. Large artery compliance and oscillatory compliance correlated negatively with age for both invasive and noninvasive groups (rϭϪ0. 50 and rϭϪ0.55; rϭϪ0.37 and rϭϪ0.66; PϽ0.001 for all). The slopes of the regression lines for the decline in oscillatory compliance with age were significantly steeper than those recorded for large artery compliance estimates. The change in blood pressure with age independently contributed to the decrease in large artery compliance but not oscillatory compliance in both groups. Consistent age-related changes were found in the pressure pulse contour by analysis of waveforms obtained invasively or noninvasively from the upper limb. The change in the oscillatory or reflective compliance estimate was independent of blood pressure change and may represent a better marker than large artery or capacitive compliance of the degenerative aging process in altering pulsatile arterial function. (Hypertension. 1999;33:1392-1398.)Key Words: age Ⅲ compliance Ⅲ resistance Ⅲ impedance A daptations in the arterial vasculature play a critical role in influencing cardiovascular hemodynamics with advancing age. 1 The generalized structural and functional changes in the arterial circulation contribute to alterations in regional blood flow, progression of atherogenesis, and the microvascular abnormalities that occur during senescence. 2 In large arteries, aging results in progressive deposition of calcium salts, fraying and fragmentation of elastin, and an increase in the number and cross-linking of collagen fibers that alter the compliance characteristics of the vessel wall. 3 A rigid aorta is less able to buffer the pulsatile output from the heart; it contributes to an increase in systolic blood pressure and left ventricular afterload and a decrease in diastolic blood pressure and impaired coronary perfusion. Recent evidence suggests that an increase in pulse pressure is accompanied by progressive vessel wall damage and atherogenesis and is associated with an increase in cardiac morbidity and mortality rates. 4,5 In addi...

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Section: Figurementioning

confidence: 99%

Age-Related Abnormalities in Arterial Compliance Identified by Pressure Pulse Contour Analysis

et al. 1999

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“…In this regard, recent studies have demonstrated that coronary distensibility is impaired in coronary sites with occult atherosclerosis.14. 30 In fact, using IVUS atherosclerosis is nearly ubiquitous in angiographically normal proximal reference segments.30 Therefore, theoretically speaking, it could be suggested that angiographically silent disease may contribute to the difficulties encountered by the catheter in negotiating the proximal coronary segments. Nevertheless, in the present study, we were unable to demonstrate any relationship between the presence of proximal disease by JVUS and the likelihood of successful imaging.…”

Section: Present Studymentioning

confidence: 99%

Feasibility of intravascular ultrasound studies: Predictors of imaging success before coronary interventions

Alfonso

Gonçalves

Goicolea

et al. 1997

Clinical Cardiology

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SummaryBackground: Intravascular ultrasound (IVUS) is currently used to study lesions during transcatheter coronary therapy. However, before dilation some lesions cannot be reached or crossed with the imaging catheter.Hypothesis: This study seeks to elucidate which factors determine the feasibility of IVUS examination before coronary interventions.Methods: Accordingly, 100 consecutive patients undergoing IVUS examination before coronary angioplasty were prospectively studied. The clinical and angiographic characteristics of 77 patients with a successful IVUS study (Group A) were compared with those of 23 patients in whom NUS was attempted but the target lesion could not be interrogated (Group B). The echogenic characteristics of the target lesion [before (n = 77) or after intervention (in 18 patients in Group B)] were also studied.Results: Patients in Group B were significantly older (62 k

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“…Congenital partial or complete coronary ostial stenosis or atresia (COSA), atherosclerosis (familial hyperlipidemia), Kawasaki disease, Takayasu aortitis, and syphilis are some of the causes for this rare condition [1][2][3][4][5][6][7][8]. In our patient, other than persistent elevation of ESR, no other abnormalities were found in the investigations suggestive of specific type of vasculitis.…”

Section: Discussionmentioning

confidence: 84%

“…Determining the exact nature and extent of the disease as well as the adequate expansion of the stent are some of the important technical consideration of the procedure in this patient. Intravascular ultrasound (IVUS) would have been extremely useful [7] in this situation but it was not performed as the facility was not available in our catheterization laboratory at that time. However, this type of urgent coronary intervention with DES may be lifesaving even without pre-procedural IVUS assessment in a resources poor setting.…”

Section: Discussionmentioning

confidence: 99%

Left Main Coronary Artery Stenting in an Adolescent: Diagnostic and Therapeutic Challenge

Kularathne¹,

Sirisena²,

Bandara³

et al. 2017

JCR

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Introduction: Coronary artery disease involving the left main stem is an extremely uncommon during adolescent life. Etiologies for such an occurrence may be congenital or acquired, that may be mainly of inflammatory in origin. Case Report: A 14 year old girl presented with acute extensive anterior myocardial infarction and cardiogenic shock. Selective coronary angiography showed isolated near total occlusion of ostial and proximal segments of left main coronary artery with dominant right coronary system, which is free of disease. Emergency Percutaneous Coronary Intervention (PCI) was performed with Evarolimus eluting coronary stent system with re-establishment of left sided coronary blood flow. She showed marked improvement following PCI and was discharged on the 7 th day of admission. Conclusion: PCI can be promising intervention for acute total or subtotal occlusion of LMCA even in adolescents, though it is technically challenging.

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Assessment of Coronary Artery Distensibility by Intravascular Ultrasound

Cited by 92 publications

References 33 publications

Age-Related Abnormalities in Arterial Compliance Identified by Pressure Pulse Contour Analysis

Age-Related Abnormalities in Arterial Compliance Identified by Pressure Pulse Contour Analysis

Feasibility of intravascular ultrasound studies: Predictors of imaging success before coronary interventions

Left Main Coronary Artery Stenting in an Adolescent: Diagnostic and Therapeutic Challenge

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