31 research outputs found
Accurate and reproducible reconstruction of coronary arteries and endothelial shear stress calculation using 3D OCT: Comparative study to 3D IVUS and 3D QCA
Background: Geometrically-correct 3D OCT is a new imaging modality with the potential to investigate the association of local hemodynamic microenvironment with OCT-derived high-risk features. We aimed to describe the methodology of 3D OCT and investigate the accuracy, inter- and intra-observer agreement of 3D OCT in reconstructing coronary arteries and calculating ESS, using 3D IVUS and 3D QCA as references.
Methods-Results: 35 coronary artery segments derived from 30 patients were reconstructed in 3D space using 3D OCT. 3D OCT was validated against 3D IVUS and 3D QCA. The agreement in artery reconstruction among 3D OCT, 3D IVUS and 3D QCA was assessed in 3-mm-long subsegments using lumen morphometry and ESS parameters. The inter- and intra-observer agreement of 3D OCT, 3D IVUS and 3D QCA were assessed in a representative sample of 61 subsegments (n ¼ 5 arteries). The data processing times for each reconstruction methodology were also calculated. There was a very high agreement between 3D OCT vs. 3D IVUS and 3D OCT vs. 3D QCA in terms of total reconstructed artery length and volume, as well as in terms of segmental morphometric and ESS metrics with mean differences close to zero and narrow limits of agreement (BlandeAltman analysis). 3D OCT exhibited excellent inter- and intra-observer agreement. The analysis time with 3D OCT was significantly lower compared to 3D IVUS.
Conclusions: Geometrically-correct 3D OCT is a feasible, accurate and reproducible 3D reconstruction
technique that can perform reliable ESS calculations in coronary arteries
Does presence of left ventricular contractile reserve improve response to cardiac resynchronization therapy? An updated meta-analysis
Background: Up to a third of patients undergoing cardiac
resynchronization therapy (CRT) do not have a clinical or
echocardiographic response. It is also unclear, whether contractile
reserve (CR) could predict CRT response. This meta-analysis examines
whether the presence of CR improves response to CRT and whether this is
modulated by other clinical factors.
Methods: Search of PubMed/EMBASE/Cochrane databases for articles
examining response to CRT stratified by the presence or not of CR.
End-point classified as clinical or echocardiographic response. The
analysis compared response to CRT (echocardiographic or clinical)
between patients with or without CR.
Results: 824 patients in 12 studies were included. The presence of left
ventricular CR was associated with a significant reduction in
echocardiographic non-responders to CRT compared to patients without CR
(OR: 0.16, 95% CI 0.08-0.33, p < 0.00001). The presence of left
ventricular CR was associated with a significant reduction in clinical
non-responders to CRT compared to patients without CR (OR: 023, 95% CI
0.14-0.37, p < 0.00001). Sensitivity analysis showed no difference in
response when pooling studies using left ventricular ejection fraction
(LVEF) or non-LVEF markers of CR. Meta-regression showed that CR was
associated with lower rates of non-responders and this was more
pronounced in patients with a narrower mean QRS complex.
Conclusions: Identification of CR is associated with improved response
to CRT. Importantly, QRS width is a potential moderator variable which
can explain part of the heterogeneity in echo response. The combination
of CR and QRS width may modulate the response to CRT. (C) 2017 Elsevier
B.V. All rights reserved
PARALLEL ADAPTATIONS IN DIET QUALITY AND PHYSICAL ACTIVITY LEVELS IN GREEK ADOLESCENTS. A BEHAVIORAL CRISIS
Predictive Role of BNP/NT-proBNP in Non-Heart Failure Patients Undergoing Catheter Ablation for Atrial Fibrillation: An Updated Systematic Review
Atrial Fibrillation (AF) is a growing public health issue, associated
with significant morbidity and mortality. In addition to pharmacological
therapy, catheter ablation is an effective strategy in restoring and
maintaining sinus rhythm. However, ablation is not without risk, and AF
recurs in a significant proportion of patients. Non-invasive, easily
accessible markers or indices that could stratify patients depending on
the likelihood of a successful outcome following ablation would allow us
to select the most appropriate patients for the procedure, reducing the
AF recurrence rate and exposure to potentially life-threatening risks.
There has been much attention paid to Brain Natriuretic Peptide (BNP)
and N-Terminal prohormone of Brain Natriuretic Peptide (NT-proBNP) as
possible predictive markers of successful ablation. Several studies have
demonstrated an association between higher pre-ablation levels of these
peptides, and a greater likelihood of AF recurrence. Therefore, there
may be a role for measuring brain natriuretic peptides levels when
selecting patients for catheter ablation
Mean arterial pressure values calculated using seven different methods and their associations with target organ deterioration in a single-center study of 1878 individuals
Impact of increased venous pressure on kidney function and mortality in cardiovascular patients with preserved ejection fraction
Vascular Abnormalities, Paraoxonase Activity, and Dysfunctional HDL in Primary Antiphospholipid Syndrome
Context Accelerated atherosclerosis has been described in
antiphospholipid syndrome, but the vascular abnormalities and the
underlying mechanisms remain unclear.
Objectives To compare vascular structure and function in patients with
positive antiphospholipid antibodies (aPL) with controls and to assess
their relationship with paraoxonase activity.
Design, Setting, and Participants A cross-sectional study of 77 women
with positive antiphospholipid antibodies from a lupus outpatient clinic
in London, England (90% of the eligible population) and 77 controls
matched on frequency basis for age and cardiovascular risk factors
between June 2006 and April 2009. Carotid intima media thickness (CIMT),
flow-mediated dilatation, pulse wave velocity, and paraoxonase activity
were measured in all patients. Anti-inflammatory and antioxidant
properties of high-density lipoprotein (HDL) were examined.
Main Outcome Measures CIMT, pulse wave velocity, flow-mediated
dilatation, and paraoxonase.
Results Women with aPL had greater CIMT and pulse wave velocity compared
with controls (mean [SD], 0.75 [0.16] vs 0.64 [0.09] mm; 95%
confidence interval [CI],-0.14 to-0.06; P<.001; and 9.2 [1.6] vs 8.5
[1.8] m/s; 95% CI,-1.14 to-0.06; P=.04) and lower flow-mediated
dilatation (6.2% [4.1%] vs 9.6% [4.2%]; 95% CI, 2.02%-4.69%;
P<.001). Paraoxonase activity was lower in women with aPL vs controls
(median [interquartile range], 91.2 [64.3-105.1] vs 103.0
[80.5-111.5] mu mol p-nitrophenol/L/serum/min; 95% CI, 0.004-0.007;
P=.005) and was inversely associated with CIMT and pulse wave velocity
in women with aPL (standardized beta coefficient=-0.4 and-0.3,
respectively; P<.05 for both), but not in the control group.
High-density lipoprotein from women with aPL inhibited endothelial
nitric oxide production in human aortic endothelial cells, in contrast
with controls. The beneficial effects of HDL from women with aPL on
vascular cell adhesion molecule 1 expression, superoxide production, and
monocyte adhesion following activation of human aortic endothelial cells
were largely blunted.
Conclusions Compared with controls, women with aPL had greater
functional and structural arterial abnormalities, which were associated
with lower activity of paraoxonase. In patients with aPL, HDL reduced
nitric oxide bioavailability and had impaired anti-inflammatory and
antioxidant properties. JAMA. 2009; 302(11): 1210-121