Intravascular ultrasound imaging of angiographically normal coronary segments in patients with coronary artery disease

Alfonso, Fernándo; Macaya, Carlos; Goicolea, Javier; ̃iguez, Andres In; Hernández, Rosana; Zamorano, José Luís; Perez-Vizcayne, Maria Jose; Zarco, Pedro

doi:10.1016/0002-8703(94)90660-2

Cited by 80 publications

(33 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The Pharmacogenomics Journal diac catheterization, interpretable quantitative coronary angiography (QCA) measurements at baseline (prior to undergoing PTCA), immediately post-PTCA (demonstrating the initial effect of the procedure) and at follow-up cardiac catheterization 6 months later, 12,13 and the availability of a blood sample for genotype determination. Restenosis was defined as Ͼ50% reduction in the luminal diameter at the site of previous PTCA, as compared with the immediate post-PTCA angiographic record; 342 patients were classified as cases.…”

Section: Methodsmentioning

confidence: 99%

Multi-locus interactions predict risk for post-PTCA restenosis: an approach to the genetic analysis of common complex disease

et al. 2002

View full text Add to dashboard Cite

The complexity of recognizing the potential contribution of a number of possible predictors of complex disorders is increasingly challenging with the application of large-scale single nucleotide polymorphism (SNP) typing. In the search for putative genetic factors predisposing to coronary artery restenosis following balloon angioplasty, we determined genotypes for 94 SNPs representing 62 candidate genes, in a prospectively assembled cohort of 342 cases and 437 controls. Using a customized coupled-logistic regression procedure accounting for both additive and interactive effects, we identified seven SNPs in seven genes that, together, showed a statistically significant association with restenosis incidence (P Ͻ0.0001), accounting for 11.6% of overall variance observed. Among them are candidate genes for cardiovascular pathophysiology (apolipoprotein-species and NOS), inflammatory response (TNF receptor and CD14), and cell-cycle control (p53 and p53-associated protein). Our results emphasize the need to account for complex multi-gene influences and interactions when assessing the molecular pathology of multifactorial medical entities.

show abstract

Section: Methodsmentioning

confidence: 99%

Multi-locus interactions predict risk for post-PTCA restenosis: an approach to the genetic analysis of common complex disease

et al. 2002

View full text Add to dashboard Cite

show abstract

“…[1][2][3] Although coronary angiography provides only a silhouette of the coronary artery lumen, the images that IVUS oVers show the coronary artery wall, plaque morphology, and plaque composition. [2][3][4][5][6] Thus the information about the coronary artery that IVUS provides can be of great use in determining coronary intervention strategies. 1 7-11 As IVUS catheter technology has improved, the range and number of patients whom IVUS can benefit has increased considerably.…”

Section: Intravascular Ultrasound (Ivus) Is An Imagingmentioning

confidence: 99%

“…(Heart 2001;85:402-406) Keywords: intravascular ultrasound; acute myocardial infarction; plaque morphology Intravascular ultrasound (IVUS) is an imaging technique that is capable of providing transluminal tomographic images of coronary arteries in vivo. [1][2][3] Although coronary angiography provides only a silhouette of the coronary artery lumen, the images that IVUS oVers show the coronary artery wall, plaque morphology, and plaque composition. [2][3][4][5][6] Thus the information about the coronary artery that IVUS provides can be of great use in determining coronary intervention strategies.…”

Section: Introductionmentioning

confidence: 99%

A combination of persistent left superior vena cava and a large secundum atrial septal defect in a 34 year old woman

Zaglavara¹

2001

Heart

View full text Add to dashboard Cite

Objective-To use intravascular ultrasound (IVUS) to compare plaque morphology in acute myocardial infarction and stable angina pectoris. Design-Retrospective study. Setting-Primary care hospital. Patients-59 consecutive cases of acute myocardial infarction and 50 consecutive cases of stable angina pectoris. Methods-IVUS was used before coronary intervention. Main outcome measures-Plaque morphology (incidence of eccentric plaque, subtle dissections, low echoic thrombus, calcification, echolucent areas, and bright speckled echo material), assessed visually using IVUS. Results-There were no significant diVerences in plaque eccentricity or calcification between the two groups, but low echoic thrombus (acute myocardial infarction 15% v stable angina pectoris 0%), subtle dissections (37% v 4%), echolucent areas (31% v 0%), and bright speckled echo material (90% v 0%) were more common in the infarction group than in the stable angina group (p < 0.001 for all). There was a longer time between the onset of symptoms and the IVUS examination in patients with low echoic thrombus than in those without (p < 0.03). Conclusions-Low echoic thrombus, subtle dissections, echolucent areas, and bright speckled echo material are morphological characteristics associated with plaque at the time of acute myocardial infarction. These findings correspond pathologically to ruptured plaque. (Heart 2001;85:402-406) Keywords: intravascular ultrasound; acute myocardial infarction; plaque morphology Intravascular ultrasound (IVUS) is an imaging technique that is capable of providing transluminal tomographic images of coronary arteries in vivo. [1][2][3] Although coronary angiography provides only a silhouette of the coronary artery lumen, the images that IVUS oVers show the coronary artery wall, plaque morphology, and plaque composition. [2][3][4][5][6] Thus the information about the coronary artery that IVUS provides can be of great use in determining coronary intervention strategies. 1 7-11 As IVUS catheter technology has improved, the range and number of patients whom IVUS can benefit has increased considerably. 3 It has further been reported that the negative contrast technique 12 and coronary injection of normal saline are useful for enhancing the diagnostic capabilities of IVUS. While the investigation and assessment of the pathological characteristics of acute coronary syndromes is quite advanced, their mechanisms are still not well understood. 13 The high incidence of thrombus in culprit lesions [14][15][16] in the acute phase of myocardial infarction is perhaps one reason why there has been insuYcient investigation of plaque in these patients. The purpose of this study was to investigate plaque morphology in vivo at the time of acute myocardial infarction, and compare it with plaque morphology in stable angina pectoris. Methods PATIENTSWe studied 59 patients with acute myocardial infarction. All patients underwent coronary angiography and IVUS before intervention. For the purpose of this study, acute myocardial infarction wa...

show abstract

“…13,14 The accuracy, reproducibility, and immediate safety of IVUS has been documented in both transplant recipients and in patients who have not undergone transplantation. 10,11,14 However, it is not known whether instrumentation of transplanted arteries affects progression of arteriopathy over several years. The purpose of this study was to examine if there was a correlation between performing IVUS examinations and the acceleration of TCAD.…”

mentioning

confidence: 99%

“…8,9 The development of intravascular ultrasound (IVUS) has allowed more accurate and sensitive detection of coronary artery disease (CAD). [10][11][12] IVUS is also more sensitive in assessing allograft vasculopathy in patients who receive heart transplantation before angiographic changes have occurred. 13,14 The accuracy, reproducibility, and immediate safety of IVUS has been documented in both transplant recipients and in patients who have not undergone transplantation.…”

mentioning

confidence: 99%

Does use of intravascular ultrasound accelerate arteriopathy in heart transplant recipients?

Son¹,

Tobis²,

Yeatman³

et al. 1999

American Heart Journal

View full text Add to dashboard Cite

Powered by the California Digital Library University of California Accelerated coronary atherosclerosis is the leading cause of long-term morbidity and mortality in heart transplant recipients. [1][2][3][4][5][6] Annual coronary angiography, which can detect severe transplantation coronary artery disease (TCAD) as early as 1 to 2 years after heart transplantation, has been used for diagnostic and surveillance purposes because patients may remain asymptomatic until myocardial infarction, congestive heart failure, cardiac arrhythmia, or sudden death develop. 3,7 Angiography is relatively insensitive for detecting early or less severe TCAD because of its diffuse nature and because the early phases of intimal hyperplasia may be associated with vessel wall expansion (positive remodeling) and minimal luminal narrowing. 8,9 The development of intravascular ultrasound (IVUS) has allowed more accurate and sensitive detection of coronary artery disease (CAD). [10][11][12] IVUS is also more sensitive in assessing allograft vasculopathy in patients who receive heart transplantation before angiographic changes have occurred. 13,14 The accuracy, reproducibility, and immediate safety of IVUS has been documented in both transplant recipients and in patients who have not undergone transplantation. 10,11,14 However, it is not known whether instrumentation of transplanted arteries affects progression of arteriopathy over several years. The purpose of this study was to examine if there was a correlation between performing IVUS examinations and the acceleration of TCAD. Methods Patient populationThe study population consisted of 95 patients who underwent heart transplantation at the University of California Los Angeles Medical Center between January 1991 and May 1995. Background Intravascular ultrasound (IVUS) is a sensitive method for assessing allograft vasculopathy in heart transplant recipients, but it is not known whether this instrumentation traumatizes the transplanted arteries and affects progression of arteriopathy. Methods and ResultsYearly coronary angiograms were obtained in 86 patients who underwent heart transplantation between January 1991 and May 1995. Patients were divided into 3 groups: (1) no IVUS performed after transplantation (group 1, n = 47); (2) IVUS of the left anterior descending artery (LAD) performed only at year 1 (group 2, n = 13); and (3) IVUS of the LAD performed at both baseline (within 2 months after transplantation) and year 1 after transplantation (group 3, n = 26). Coronary angiography measurements of lumen diameter were performed at 5 segments along the length of the LAD and left circumflex artery (LCX) from baseline through the second-year studies except in group 2, which did not receive a baseline angiogram; IVUS measurements were obtained at 10 cross sections from each artery. At baseline, there was no significant difference in vessel diameter for either the LAD or the LCX artery between the IVUS (group 3) and no IVUS (group 1) groups. Within each group, the lumen of both the LAD and LCX nar...

show abstract

Intravascular ultrasound imaging of angiographically normal coronary segments in patients with coronary artery disease

Cited by 80 publications

References 24 publications

Multi-locus interactions predict risk for post-PTCA restenosis: an approach to the genetic analysis of common complex disease

Multi-locus interactions predict risk for post-PTCA restenosis: an approach to the genetic analysis of common complex disease

A combination of persistent left superior vena cava and a large secundum atrial septal defect in a 34 year old woman

Does use of intravascular ultrasound accelerate arteriopathy in heart transplant recipients?

Contact Info

Product

Resources

About