Coronary artery atherosclerosis: severity of the disease, severity of angina pectoris and compromised left ventricular function.

Leaman, David M.; Brower, R. W.; Meester, Geert T.; Serruys, Patrick W.; Brand, Marcel van den

doi:10.1161/01.cir.63.2.285

Cited by 213 publications

(136 citation statements)

References 34 publications

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“…Briefly, using cardiac output, blood flow through the artery undergoing stenting was determined assuming the coronary arteries receive 5% of the cardiac output, and the right and left coronary arteries receive 16% and 84%, respectively (Ellwein et al, 2011 andLeaman et al, 1981). A typical coronary inflow waveform (Fig.…”

Section: Cfd Simulationsmentioning

confidence: 99%

Computational replication of the patient-specific stenting procedure for coronary artery bifurcations: From OCT and CT imaging to structural and hemodynamics analyses

Chiastra

Dickerhoff

et al. 2016

Journal of Biomechanics

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The optimal stenting technique for coronary artery bifurcations is still debated. With additional advances computational simulations can soon be used to compare stent designs or strategies based on verified structural and hemodynamics results in order to identify the optimal solution for each individual's anatomy. In this study, patient-specific simulations of stent NOT THE PUBLISHED VERSION; this is the author's final, peer-reviewed manuscript. The published version may be accessed by following the link in the citation at the bottom of the page. Biomechanics, Vol 49, No. 11 (July 26, 2016): pg. 2102-2111. DOI. This article is © Elsevier Ltd. and permission has been granted for this version to appear in e-Publications@Marquette. Elsevier Ltd. does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Elsevier Ltd. Journal of3 deployment were performed for 2 cases to replicate the complete procedure conducted by interventional cardiologists. Subsequent computational fluid dynamics (CFD) analyses were conducted to quantify hemodynamic quantities linked to restenosis.Patient-specific pre-operative models of coronary bifurcations were reconstructed from CT angiography and optical coherence tomography (OCT). Plaque location and composition were estimated from OCT and assigned to models, and structural simulations were performed in Abaqus. Artery geometries after virtual stent expansion of Xience Prime or Nobori stents created in SolidWorks were compared to post-operative geometry from OCT and CT before being extracted and used for CFD simulations in SimVascular. Inflow boundary conditions based on body surface area, and downstream vascular resistances and capacitances were applied at branches to mimic physiology.Artery geometries obtained after virtual expansion were in good agreement with those reconstructed from patient images. Quantitative comparison of the distance between reconstructed and post-stent geometries revealed a maximum difference in area of 20.4%. Adverse indices of wall shear stress were more pronounced for thicker Nobori stents in both patients. These findings verify structural analyses of stent expansion, introduce a workflow to combine software packages for solid and fluid mechanics analysis, and underscore important stent design features from prior idealized studies. The proposed approach may ultimately be useful in determining an optimal choice of stent and position for each patient.

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Section: Cfd Simulationsmentioning

confidence: 99%

Computational replication of the patient-specific stenting procedure for coronary artery bifurcations: From OCT and CT imaging to structural and hemodynamics analyses

Chiastra

Dickerhoff

et al. 2016

Journal of Biomechanics

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“…This scoring system was developed from a combination of various grading systems, such as Bypass Angioplasty Revascularization Investigation (BARI) protocol, modified Arterial Revascularization Therapies Study ARTS, modified Leaman score, American College of Cardiology/American Heart Association (ACC/AHA) classification system, Duke and International Classification for Patient Safety, and the total occlusion classification grading system (18)(19)(20)(21)(22)(23). The SS is based on complex parameters such as diameter reduction and the number of lesions, total occlusions, bifurcation or trifurcation lesions, aorto-ostial stenosis, tortuosity, length, calcification, thrombus, and widespread disease or small vessels (18).…”

Section: Syntax Scorementioning

confidence: 99%

An Important Question That Needs to Be Proved: Is There Any Relationship between the Epicardial Fat Thickness and the Coronary Artery Complexity in Patients with Acute Non-ST Elevation Myocardial Infarction?

Karakurt¹,

Yıldız²

2017

Erciyes Med J

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Objective: In this study, we aimed to investigate the association of epicardial fat thickness (EFT) and coronary artery lesion complexity with patients having acute non-ST elevation myocardial infarction (NSTEMI). Materials and Methods:The patients (n=328) were divided into low syntax score (SS) group (SS≤17; Low-SSG), intermediate SS group (SS=18-28; In-SSG), and high SS group (SS≥29; High-SSG) based on the SS value. EFT, SS, distributions of the critical coronary artery lesions, and the neutrophil-lymphocyte ratio (NLR) were determined for all the groups. EFT was measured by transthoracic echocardiography and was recorded on a digital storage device.Results: High-SSG had a significantly higher mean of EFT (6.65±0.82 mm) when compared to Low-SSG (5.12±1.13 mm) and In-SSG (5.79±0.83 mm) (p<0.001). EFT showed a significant positive correlation with SS (r=0.607, p<0.001). Further, a significant positive correlation was revealed with the distributions of critical coronary artery lesions of the left anterior descending (LAD), circumflex artery (Cx), and right coronary artery (RCA) (r=0. 260, p<0.001; r=0.213, p=0.001; and r=0.275, p<0.001, respectively). However, no correlation was demonstrated between EFT and NLR (r=0.081, p=0.145) in patients with NSTEMI. Conclusion:These results showed that EFT is significantly associated with coronary artery lesion complexity in patients with NSTEMI and can work as a risk marker in these patients.

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“…Three methods were employed in assessing the severity of atherosclerotic burden which included Gensini, Leaman and vessel score. [16][17][18] In STEMI patients, Killip classes, TIMI (Thrombolysis In Myocardial Infarction), GRACE (Global Registry of Acute Coronary Events) and modified Selvester ECG (electrocardiographic) QRS scores were used in assessing the severity of myocardial infarction. [19][20][21][22] We found that TT levels were low, while hs-CRP levels were high in patients with angiographically-proven CAD compared to controls ( Table 1).…”

Section: Main Studymentioning

confidence: 99%

Novel risk factors for coronary artery disease – role of testosterone and high-sensitivity CRP in Sri Lankan males

Wickramatilake

2017

J of Cey Coll of Phy

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Coronary artery disease (CAD) is multi-factorial in origin and develops as a result of both genetic and environmental factors. Traditional risk factors (generally smoking, hypertension, raised lipids, and diabetes mellitus) do not explain all of the risk for coronary disease events. There remain several other factors that contribute to the overall risk. Various new or emerging risk factors have been studied to improve global risk assessment for CAD. Inflammation indicated by markers as Creactive protein and low androgen (testosterone) status in males are among the emerging risk factors. In the local setting, the association of testosterone with CAD has not been explored, although this relationship has been well-studied in the Western population. Therefore we investigated, whether serum levels of total testosterone (TT) and high sensitivity C-reactive protein (hs-CRP) differ in men with CAD from those without CAD and to evaluate the relationship of serum TT and hs-CRP with the severity of CAD.Three hundred and nine males (103 patients with ST-elevation myocardial infarction (STEMI), 103 patients with angiographically-proven CAD, 103 controls without having a history of CAD) were studied. Serum TT, hs-CRP, lipids, cardiac troponin I (cTnI) and plasma glucose were estimated. Three angiogram-based severity scores were used in the severity assessment of angiographically-proven CAD. In STEMI patients, clinical risk scores and modified Selvester ECG QRS score were used in assessing the severity of myocardial infarction.We showed that low levels of total testosterone, high levels of hs-CRP, abnormal lipid profile and raised plasma glucose contribute to an atherogenic milieu. Low levels of total testosterone and high level of hs-CRP can be perceived as risk factors of coronary artery disease.

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Coronary artery atherosclerosis: severity of the disease, severity of angina pectoris and compromised left ventricular function.

Cited by 213 publications

References 34 publications

Computational replication of the patient-specific stenting procedure for coronary artery bifurcations: From OCT and CT imaging to structural and hemodynamics analyses

Computational replication of the patient-specific stenting procedure for coronary artery bifurcations: From OCT and CT imaging to structural and hemodynamics analyses

An Important Question That Needs to Be Proved: Is There Any Relationship between the Epicardial Fat Thickness and the Coronary Artery Complexity in Patients with Acute Non-ST Elevation Myocardial Infarction?

Novel risk factors for coronary artery disease – role of testosterone and high-sensitivity CRP in Sri Lankan males

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