Experimental validation and clinical comparison of quantitative coronary analysis systems

The kernel topic of this thesis is the validation of QCA systems by a new experimental approach involving the percutaneous insertion of coronary stenosis phantoms in swine coronary arteries. The reliability of digital as well as cinefilm-based QCA systems has been compared on the basis of this experimental approach using different calibration techniques as well as on the basis of more traditional in vitro experiments and the practical value of various quantitative geometric parameters is discussed. In a comparative analysis with geometric coronary measurements, currently available software packages for videodensitometric analysis have been validated using experimental and clinical data and the potential role of videodensitometry for intracoronary volume estimation has been evaluated. Furthermore, on-line and off-line techniques for estimation of coronary flow reserve have been compared. Finally, the assessment of coronary artery luminal dimensions by intracoronary ultrasound has been compared with corresponding measurements obtained by quantitative angiography and basic m

High-pressure spin shifts in the pseudogap regime of superconducting YBa2Cu4O8 as revealed by 17O NMR

A new NMR anvil cell design is used for measuring the influence of high pressure on the electronic properties of the high-temperature superconductor YBa$_2$Cu$_4$O$_8$ above the superconducting transition temperature $T_{\rm c}$. It is found that pressure increases the spin shift at all temperatures in such a way that the pseudo-gap feature has almost disappeared at 63 kbar. This change of the temperature dependent spin susceptibility can be explained by a pressure induced proportional decrease (factor of two) of a temperature dependent component, and an increase (factor of 9) of a temperature independent component, contrary to the effects of increasing doping. The results demonstrate that one can use anvil cell NMR to investigate the tuning of the electronic properties of correlated electronic materials with pressure.Comment: 4 pages, 4 figures, accepted for publication in Phys. Rev.

Edge detection versus densitometry in the quantitative assessment of stenosis phantoms: an in vivo comparison in procine coronary arteries

The aim of this study was the in vivo validation and comparison of the geometric and densitometric technique of a computer-assisted automatic quantitative angiographic system (CAAS system). In six Landrace Yorkshire pigs (45 to 55 kg), precision-drilled phantoms with a circular lumen of 0.5, 0.7, 1.0, 1.4, and 1.9 mm were percutaneously introduced into the left anterior descending or left circumflex coronary artery. Twenty-eight coronary angiograms obtained with the phantom in a wedged intracoronary position could be quantitatively analyzed. Minimal lumen diameter, minimal cross-sectional area, percent diameter stenosis, and cross-sectional area stenosis were automatically measured with both the geometric and densitometric technique and were compared with the known phantom dimensions. When minimal lumen diameter was measured using the geometric approach, a nonsignificant underestimation of the phantom size was observed, with a mean difference of -0.06 +/- 0.14 mm. The larger mean difference observed with videodensitometry (-0.11 +/- 0.20 mm) was the result of the failure of the technique to differentiate the low lumen videodensities of two phantoms of smaller size (0.5 and 0.7 mm) from a dense background. Percent cross-sectional area stenosis measured with the two techniques showed a good correlation with the corresponding phantom measurements (mean difference between percent cross-sectional area stenosis calculated from the quantitative angiographic measurements and the corresponding phantom dimensions was equal to 2 +/- 6% for both techniques, correlation coefficient = 0.93 with both techniques, SEE = 5% with the geometric technique and 6% with the densitometric approach).(ABSTRACT TRUNCATED AT 250 WORDS

Can the same edge-detection algorithm be applied to on-line and off-line analysis systems? Validation of a new cinefilm-based geometric coronary measurement software

In the Cardiovascular Measurement System (CMS) the edge-detection algorithm, which was primarily designed for the Philips digital cardiac imaging system (DCI), is applied to cinefilms. Comparative validation of CMS and DCI was performed in vitro and in vivo with intracoronary insertion of stenosis phantoms in anesthetized pigs. The "obstruction diameter" (OD) was measured at the artificial stenoses visualized by angiography with calibration at the isocenter (ISO) and catheter calibration (CATH) and compared with the true phantom diameters. A clinical comparison of OD, reference diameter (RD), and percentage diameter stenosis (DS) was performed on 70 corresponding images from post-PTCA angiograms. In vitro, OD (CMS) yielded an accuracy of 0.18 +/- 0.14 mm with 100% (correlation coefficient: r = 0.97, y = 0.06 + 0.75x, standard error of estimate [SEE] = 0.09) and 0.19 +/- 0.15 mm with 50% contrast (r = 0.94, y = 0.02 + 0.81 x). OD (DCI) yielded an accuracy of 0.11 +/- 0.06 mm with 100% (r = 0.99, y = -0.03 + 0.91 x, SEE = 0.05) and 0.24 +/- 0.13 mm with 50% contrast (r = 0.94, y = 0.29 + 6.69 x, SEE = 0.12). In vivo, OD (CMS) yielded an accuracy of 0.18 +/- 0.23 mm with ISO (r = 0.89, y = 0.02 + 0.83 x, SEE = 0.22) and 0.26 +/- 0.24 mm with CATH (r = 0.89, y = 0.06 + 0.72 x, SEE = 0.19). OD (DCI) yielded an accuracy of 0.08 +/- 0.15 mm with ISO (r = 0.96, y = 0.08 + 0.86 x, SEE = 0.14) and 0.18 +/- 0.21 mm with CATH (r = 0.92, y = 0.09 + 0.76 x, SEE = 0.17). The clinical comparison showed reasonable agreement for OD only (r = 0.81, y = 0.26 + 0.81 x, SEE = 0.29). Transformation of an edge-detection algorithm from a digital to a cinefilm-based system can lead to impairment of measurement reliability

In vivo validation of an experimental adaptive quantitative coronary angiography algorithm to circumvent overestimation of small luminal diameters

The reliability of quantitative coronary angiography (QCA) measurements is of fundamental importance for the study and practice of interventional cardiology. In vivo validation results have consistently reported a tendency for QCA systems to overestimate small luminal diameters. Such a systematic error may result in the underestimation of luminal gain during intracoronary procedures and in the underestimation of progression of coronary artery disease during longitudinal studies. We report the in vivo validation results of an experimental adaptive edge‐detection algorithm that was developed to reduce overestimation of small luminal diameters by incorporating a dynamic function of variable kernel size of the derivative operator and variable weighting of the first and second derivatives of the brightness profile. The results of the experimental algorithm were compared to those of the conventional parent edge detection algorithm with fixed parameters. Dynamic adjustment of the edge‐detection algorithm parameters was found to improve measurements of small (lt;0.8‐mm) luminal diameters as evidenced by an intercept of +.07 mm for the algorithm with variable weighting compared to +0.21 mm for the parent algorithm with fixed weighting. A slope of <1 was found for both the parent and experimental algorithms with subsequent underestimation of large luminal diameters. S

pEPito: a significantly improved non-viral episomal expression vector for mammalian cells

<p>Abstract</p> <p>Background</p> <p>The episomal replication of the prototype vector pEPI-1 depends on a transcription unit starting from the constitutively expressed <it>Cytomegalovirus </it>immediate early promoter (CMV-IEP) and directed into a 2000 bp long <it>matrix attachment region sequence </it>(MARS) derived from the human β-interferon gene. The original pEPI-1 vector contains two mammalian transcription units and a total of 305 CpG islands, which are located predominantly within the vector elements necessary for bacterial propagation and known to be counterproductive for persistent long-term transgene expression.</p> <p>Results</p> <p>Here, we report the development of a novel vector pEPito, which is derived from the pEPI-1 plasmid replicon but has considerably improved efficacy both <it>in vitro </it>and <it>in vivo</it>. The pEPito vector is significantly reduced in size, contains only one transcription unit and 60% less CpG motives in comparison to pEPI-1. It exhibits major advantages compared to the original pEPI-1 plasmid, including higher transgene expression levels and increased colony-forming efficiencies <it>in vitro</it>, as well as more persistent transgene expression profiles <it>in vivo</it>. The performance of pEPito-based vectors was further improved by replacing the CMV-IEP with the <it>human CMV enhancer/human elongation factor 1 alpha promoter </it>(hCMV/EF1P) element that is known to be less affected by epigenetic silencing events.</p> <p>Conclusions</p> <p>The novel vector pEPito can be considered suitable as an improved vector for biotechnological applications <it>in vitro </it>and for non-viral gene delivery <it>in vivo</it>.</p

Coronary arteriography for quantitative analysis: experimental and clinical comparison of cinefilm and video recordings.

Although use of videotape for the recording of coronary angiograms continues to grow, the validity of quantitative coronary angiographic analysis of video images remains unknown. To estimate the realibility of angiographic images recorded on videotapes, experimental and clinical angiograms were recorded simultaneously on both 35 mm cinefilm and super-VHS videotape with normal images and with spatial filtering of the images (edge enhancement) on a digital cardiac imaging system. The experimental angiographic studies were performed with plexi

Comparative validation of quantitative coronary angiography systems. Results and implications from a multicenter study using a standardized approach.

Background Computerized quantitative coronary angiography (QCA) has fundamentally altered our approach to the assessment of coronary interventional techniques and strategies aimed at the prevention of recurrence and progression of stenosis. It is essential, therefore, that the performance of QCA systems, upon which much of our scientific understanding has become integrally dependent, is evaluated in an objective and uniform manner. Methods and Results We validated 10 QCA systems at core laboratories in North America and Europe. Cine films were made of phantom stenoses of known diameter (0.5 to 1.9 mm)