Contrast-enhanced ultrasound imaging of the vasa vasorum of carotid artery plaque

The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.

Relation between Carotid Artery Plaques Characteristics as a Predictor of Haemodynamics Changes after Carotid Artery Stenting

Objectives: To study relationship between carotid artery plaques characteristics and haemodynamic changes after carotid stenting. Patients and Methods: This observational prospective (pilot) study included 20 patients—who underwent CAS. The study was carried out in Ain shams university hospitals—Railway hospital (ERMED) and Suez insurance hospital from December 2018 to February 2020. Inclusion criteria, Symptomatic (defined as amaurosis fugax, TIA, Minor stroke or Major stroke) stenosis > 70%. Asymptomatic stenosis > 80% (accidentally discovered during pre-operative assessment for CABG and during full assessment for irrelevant stroke). Results: Regarding to plaque character for degree of stenosis, calcification and ulceration revealed significantly higher degree of stenosis in hemodynamic events group (P = 0.024). On the other hand, that there was no statistically significant difference between the two groups as regard calcification, ulceration and lesion location. Conclusion: The study revealed that HI is a common occurrence following CAS procedures and significantly higher degree of stenosis in hemodynamic events group. Plaque shape, ulcerations hardly affect haeodynamic instability after carotid stenting.

Assessment of neovascularization within carotid plaques in patients with ischemic stroke

AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were studied.The thickest soft plaque in each patient was examined using contrast-enhanced ultrasound.Time-intensity curves were collected from 5 s to 3 min after contrast injection.The neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the patients.RESULTS:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P < 0.001 comparing grade Ⅳ plaque with grade I plaque and with grade Ⅱ plaque and P = 0.001 comparing grade Ⅲ plaque with grade Ⅰ plaque and with grade Ⅱ plaque).Analysis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P < 0.01).The wash-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P < 0.05).The sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,respectively.There was no significant difference in the peak intensity or time to peak between the 2 groups.CONCLUSION:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic stroke.The data suggest that the presence of neovascularization is a marker for unstable plaque.

Association between Serum Alkaline Phosphatase and Carotid Atherosclerosis in a Chinese Population: A Community-based Cross-sectional Study

Objective This study aimed to investigate the relationship between alkaline phosphatase(ALP) and common carotid intima media thickness(IMT), carotid plaque, and extracranial carotid artery stenosis(ECAS). Methods A total of 3,237 participants aged ≥ 40 years were recruited from Jidong community in 2013-2014. Participants were divided into five quintile groups based on their serum ALP levels. Carotid atherosclerosis was assessed using ultrasound. Abnormal IMT, carotid plaque, and ECAS were defined as IMT > 0.9 mm, IMT > 1.5 mm, and ≥ 50% stenosis in at least one extracranial carotid artery, respectively. Results Common carotid IMT values and the prevalence of carotid plaque increased across serum ALP quintiles. Higher ALP quintiles were correlated with an increased risk of abnormal IMT [fourth quintile: odds ratio(OR) 1.78, 95% confidence interval(CI) 1.13-2.82, P = 0.0135;fifth quintile: OR = 1.82, 95% CI: 1.15-2.87, P = 0.0110] and ECAS compared to the lowest quintile(fifth quintile: OR = 1.47, 95% CI: 1.09-1.97, P = 0.0106). The association between ALP and prevalence of carotid plaque became insignificant after adjustment for confounders. Conclusion Serum ALP levels were independently associated with abnormal common carotid IMT and ECAS. These conclusions need to be further corroborated in future prospective cohort studies.

Association between Fundus Atherosclerosis and Carotid Arterial Atherosclerosis

Objective: To investigate the correlation between fundus atherosclerosis and carotid arterial atherosclerosis. Methods: A total of 516 people undergoing physical examination in Deyang People’s Hospital between June 2020 and December 2022 were randomly selected. Fundus atherosclerosis and carotid arterial atherosclerosis were evaluated by fundus photography and carotid artery ultrasonography, respectively. Results: Among the 516 physical examination patients, 198 (38.4%) had normal fundus examination, and 318 (61.6%) had fundus arteriosclerosis. Among them, 166 cases were of grade I (32.2%), 86 cases were of grade II (16.7%), and 66 cases were of grade III (12.8%). There were 286 cases (55.4%) without carotid atherosclerosis, 201 cases (38.9%) with carotid atherosclerotic plaque, and 33 cases (6.4%) with carotid stenosis. Fundus arteriosclerosis is independently associated with carotid artery intima-media thickness, vulnerable plaques, plaque scores, and carotid artery stenosis (P Conclusion: In summary, there is a close relationship between carotid artery disease and the degree of arteriosclerosis in the eyeground. Fundus photography is a simple, non-invasive, and easily acceptable method of inspection. The results obtained from it are useful in determining the severity of carotid atherosclerosis and guiding early detection and intervention in clinical cases. This can help reduce the incidence of cardiovascular and cerebrovascular diseases.

Correlation of the history of stroke and the retinal artery occlusion: a nested case-control study

AIM:To analyze the systemic factors including stroke history related to the retinal artery occlusion(RAO).METHODS:Patients with an exact diagnosis of RAO in the medical database of the Kailuan Corporation were identified as the case group.Five patients without RAO were added for each case from the Kailuan Study and matched for sex and age(age±2)as the control group.The Kailuan Study is a general population-based cohort study in northern China,in which a total of 101510 individuals(81110 men)aged 18-98 y were recruited to participate in the study.And the participants were bi-annually reexamined.The database of both groups was from Kailuan study of 2010 cohort.All the information,including the demographic characteristics,lifestyle behaviors,medical comorbidities,medical history,family medical history,drug usage,anthropometric measurements,blood pressure measurement,blood sample laboratory assessment,urine tests,and other physical examinations were all collected.A retrospective nested case-control method was used for this study.Conditional multivariate logistic regression was used to analyze the risk factors with SPSS 13.0 software and SAS 9.3 software.RESULTS:A total of 45 patients were included as the case group,and the control group included 225 patients.In the case group,28 patients(62.2%)had a central retinal artery occlusion(CRAO),and 17 patients(37.8%)had a branch retinal artery occlusion(BRAO).A total of 18 patients(40.0%)had a stroke before the RAO(mean 4.04±3.88 y before the RAO),and 31 patients(81.6%)had infarctions or malacia identified by the cranial computed tomography(CT)scans.The basal ganglia and centrum semiovale were the most frequently involved regions.Plaques in the common carotid artery were present in 32 patients(88.9%).Conditional multivariate logistic regression analysis showed that the RAO was found to be associated with the history of stroke(P=0.0023,OR=28.794;95%CI:3.322-249.586).CONCLUSION:A history of stroke can significantly increase the incidence of RAO.Exists of plaque in the carotid artery is mean more than its severe stenosis for RAO.

超声联合Framingham危险评分在冠状动脉粥样硬化预测中的应用

目的:探讨外周动脉(颈动脉、股动脉)斑块超声联合Framingham危险评分对冠状动脉粥样硬化(coronary atherosclerosis,CA)的预测价值。方法:选取我院心内科收治的CA疑似病例108例作为研究对象,冠状动脉造影有CA(CA组,78例),30例无CA(正常组)。分析两组CA的临床危险因素,计算Framingham总分。对两组进行外周动脉(颈动脉、股动脉)斑块超声检查并计算斑块超声等级评分(plaque score,PS)。分析颈动脉PS、股动脉PS、Framingham总分单用及联用对CA的预测效能。结果:与正常组相比,CA组的平均年龄更大,吸烟率更高、HDL-C水平更低,颈动脉斑块数、股动脉斑块数明显更多,颈动脉PS、股动脉PS、Famingham评分及Gensini总分明显更高(P<0.05)。CA患者的颈动脉PS、股动脉PS、Famingham评分均与Gensini评分呈正相关(P<0.05),其中股动脉PS的相关系数最大。颈动脉PS、股动脉PS、Famingham评分单独诊断CA的曲线下面积(AUC)分别为0.813(95%CI:0.608~0.940)、0.823(95%CI:0.620~0.945)、0.790(95%CI:0.700~0.979),三项联合诊断CA的AUC值为0.890(95%CI:0.700~0.979),三项联合对CA的诊断效能高于三项单用(P<0.05)。结论:外周动脉(颈动脉、股动脉)斑块超声、Framingham评分对CA均有一定的诊断效能,三项联用可提高预测CA的准确性。

Plaque components affect wall stress in stented human carotid artery: A numerical study

Carotid artery stenting presents challenges of in-stent restenosis and late thrombosis, which are caused primarily by alterations in the mechanical environment of the artery after stent implantation. The present study constructed patient-specific carotid arterial bifurcation models with lipid pools and calcified components based on magnetic resonance imaging. We numerically analyzed the effects of multicomponent plaques on the distributions of von Mises stresses (VMSs) in the patient-specific models after stenting. The results showed that when a stent was deployed, the large soft lipid pool in atherosclerotic plaques cushioned the host artery and reduced the stress within the arterial wall; however, this resulted in a sharp increase of VMS in the fibrous cap. When compared with the lipid pool, the presence of the calcified components led to slightly increased stresses on the luminal surface. However, when a calcification was located close to the luminal surface of the host artery and the stenosis, the local VMS was elevated. Overall, compared with calcified components, large lipid pools severely damaged the host artery after stenting. Furthermore, damage due to the calcified component may depend on location.

Relationship between platelet-lymphocyte ratio and carotid atherosclerosis in middle-aged and elderly patients with type 2 diabetes mellitus

Objective:To investigate the relationship between platelet-lymphocyte ratio(PLR)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with T2DM.Methods:A total of 420 middle-aged and elderly patients with T2DM who were hospitalized in the Endocrinology Department of our hospital from September 2018 to September 2020 and were examined by ultrasound were selected as the subjects.The carotid artery intima-media thickness(CIMT)was examined by color Doppler ultrasonography,including normal CIMT group(n=111),CIMT thickening group(n=103)and CAS plaque group(n=206).The differences of serum PLR levels among the three groups were compared.Multivariate Logistic regression was used to analyze the relationship between PLR and CAS plaque formation.The receiver operating curve(ROC)was used to evaluate the value of multivariate Logistic regression model(Logit P)in the diagnosis of CAS lesions.Results:The mean value of PLR in CAS plaque group(127.86±48.54)was significantly higher than that in CIMT normal group(109.15±48.35).Multivariate Logistic regression analysis showed that after adjusting for other confounding factors,the increase of PLR was an independent risk factor for the occurrence of CAS plaque.ROC showed that the efficacy of multivariate Logit P model in the diagnosis of CAS plaque was(AUC=0.807,95%CI=0.759-0.858).Conclusions:PLR is one of the important risk factors for the occurrence of CAS lesions.At the same time,the multivariate Logistic regression model established in this study has clinical reference value in predicting CAS lesions in middle-aged and elderly patients with T2DM.

Correlation of carotid plaque vulnerability with lipid metabolism, inflammatory response and protease activity in patients with coronary artery disease

Objective: To study the correlation of carotid plaque vulnerability with lipid metabolism, inflammatory response and protease activity in patients with coronary artery disease. Methods: Patients who were diagnosed with coronary heart disease combined with carotid atherosclerosis in People's Hospital of Dongxihu District Wuhan City between April 2015 and October 2017 were selected and divided into vulnerable group and stable group according to ultrasonic judgment of carotid plaque vulnerability;the healthy volunteers who underwent physical examination during the same period were selected as the control group. The serum was collected to determine the contents of lipid metabolism, inflammatory response and protease activity indexes, and the peripheral blood was collected to determine the expression of inflammatory response indexes. Results: LDL-C, Lp(a), CXCL5, E-selectin, CatK and Meprin- levels in serum as well as ERK1/2, NF-κB and TNF-α expression in peripheral blood of stable group and vulnerable group were significantly higher than those of control group whereas ATGL, Omentin-1, Vaspin, PAI-1, TIMP1 and TIMP2 levels were significantly lower than those of control group;LDL-C, Lp(a), CXCL5, E-selectin, CatK and Meprin-levels in serum as well as ERK1/2, NF-κB and TNF-α expression in peripheral blood of vulnerable group were significantly higher than those of stable group whereas ATGL, Omentin-1, Vaspin, PAI-1, TIMP1 and TIMP2 levels were significantly lower than those of stable group. Conclusion: The changes of carotid plaque vulnerability in patients with coronary artery disease are closely related to the changes in lipid metabolism, inflammatory response and protease activity in the course of disease.

18F-FDG PET/CT for Detecting Vulnerable Carotid Plaque:A Systematic Review of Literatures

Objectives:To evaluate the efficacy of 18F-FDG-PET/CT in detection toward the vulnerabilities of carotid plaque and review systematically best evidence to prevent acute stroke from unstable carotid plaque.Methods:A search was conducted on Medline(PubMed),Web of science,Cochrane and WHIC using the search terms‘PET/CT’AND‘18F-FDG’AND‘fluorodeoxyglucose’AND‘carotid plaque’,from 2013/01/01 to now.Two authors will independently extract data following the study characteristics,eligibility criteria,interventions,outcome measurements,duration,adverse events,results and the type of needle used.All searched articles were inserted into in EndNote software that can automatically save,manage,and delete duplicate documents.Results:There were 3 articles included in the systematic review finally and form the study population analysis.The total 89 patients(64 males and 25 females)identified from the included studies.The mean 18F-FDG injected dose was 4.58 MBq/kg.The last three articles have demonstrated that 18F-FDG can accurately identify the stability of carotid plaques and can accurately locate and identify high-inflammation areas by histological analysis.Conclusions:18F-FDG-PET/CT is very efficient and practical for the identification of carotid vulnerable plaques.TBR(max and mean values)as a parameter for identifying inflammatory plaques is more reliable than SUV.

The Effect of Carotid Plaque Morphology on Longitudinal Fibrous Cap Stress Levels

Background and Purpose: Rupture of vulnerable carotid atherosclerotic plaques is a major cause of stroke. Stress levels may reflect risk of rupture in patients with carotid atherosclerotic plaques. Features thought to influence the risk of plaque rupture include the degree of stenosis, lipid-rich necrotic core (LR-NC) size, and thickness of the protective fibrous caps. We used computational models to investigate the effect of these variables on fibrous cap stress levels. Methods: Two-way coupled fluid-structure interaction longitudinal 2D simulations were performed on a bifurcation model based on idealized geometry derived from a symptomatic patient. Models with varying degrees of stenosis (50%-95%), fibrous cap thicknesses (0.05-1 mm), and LR-NC sizes (2 × 1 mm-6 × 3 mm) were simulated. The stress distribution for each model was calculated and peak principal stresses extracted. Regression analysis was used for assessing the relationship between the variables and stress levels. Results: Mechanical stresses increased with decreasing fibrous cap thicknesses ( β= -0.905, p Conclusions: Thin-capped plaques with large atheromas, known predictors of plaque vulnerability, were shown to exhibit the greatest mechanical stress levels.

Atherosclerosis imaging using 3D black blood TSE SPACE vs 2D TSE

AIM: To compare 3D Black Blood turbo spin echo(TSE)sampling perfection with application-optimized contrast using different flip angle evolution(SPACE) vs 2D TSE in evaluating atherosclerotic plaques in multiple vascular territories. METHODS: The carotid, aortic, and femoral arterial walls of 16 patients at risk for cardiovascular or atherosclerotic disease were studied using both 3D black blood magnetic resonance imaging SPACE and conventional 2D multi-contrast TSE sequences using a consolidated imaging approach in the same imaging session. Qualitative and quantitative analyses were performed on the images. Agreement of morphometric measurements between the two imaging sequences was assessed using a two-sample t-test, calculation of the intra-class correlation coefficient and by the method of linear regression and Bland-Altman analyses. RESULTS: No statistically significant qualitative differences were found between the 3D SPACE and 2D TSE techniques for images of the carotids and aorta. For images of the femoral arteries, however, there were statistically significant differences in all four qualitative scores between the two techniques. Using the current approach, 3D SPACE is suboptimal for femoral imaging. However, this may be due to coils not being optimized for femoral imaging. Quantitatively, in our study, higher mean total vessel area measurements for the 3D SPACE technique across all three vascular beds were observed. No significant differences in lumen area for both the right and left carotids were observed between the two techniques. Overall, a significant-correlation existed between measures obtained between the two approaches. CONCLUSION: Qualitative and quantitative measurements between 3D SPACE and 2D TSE techniques are comparable. 3D-SPACE may be a feasible approach in the evaluation of cardiovascular patients.

Expansive arterial remodeling of carotid arteries in symptomatic ischemic patients

Purpose: The present study aimed to assess the associations of expansive remodeling of carotid arteries with ischemic symptoms and the degree of stenosis. Materials and Methods: A total of 41 symptomatic patients with vulnerable plaques and 25 asymptomatic individuals with stable plaques were included. All patients underwent 3.0T high-resolution MRI of the carotid artery(CA) for measuring the expansive remodeling(ER) ratio and assessing plaque stability. The ER ratio was calculated by dividing the maximum distance between the lumen and the outer border of the plaque in the internal CA by the lumen diameter within 1 centimeter of the plaque at the distal ipsilateral internal CA. ER ratios were compared between the symptomatic and asymptomatic groups. The 41 symptomatic patients were further divided into 4 groups according to stenosis rate(CA stenosis <50%, 50%–74%, 75–89%, and > 90%), and the correlation between the ER ratio and the rate of stenosis was evaluated. Results: There was a significant difference in ER ratio between the symptomatic and asymptomatic groups(p<0.001). When symptomatic patients were divided into 4 subgroups based on degree of stenosis, ER ratios among groups showed statistically significant differences(p=0.014). Conclusion: There were significant associations of the ER ratio with ischemic symptoms. Furthermore, the ER ratio in symptomatic patients continued to increase with stenosis severity. These findings suggested that the ER ratio might be a practical marker of plaque vulnerability in the CA and further prospective studies for asymptomatic patients are warranted.

Evaluation of Carotid Atherosclerotic Plaque Stability with Contrast-enhanced Ultrasonography

This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography. Fifty patients with carotid atherosclerotic plaques were enrolled and examined with contrast-enhanced ultrasonography. The correlation of contrast agent enhancement of the carotid atherosclerotic plaques and the clinical symptoms was analyzed. The results showed that among the 50 patients, plaques were enhanced in the 23 patients with obvious clinical symptoms. In 27 patients without apparent clinical symptoms, plaques were enhanced sparsely in 15 patients and not enhanced in 12 patients. It was suggested that contrast-enhanced ultrasonography could be used for the examination of the microcirculation in carotid atherosclerotic plaques on real-time basis and serve as a new noninvasive approach for the assessment of stability of carotid atherosclerotic plaques.

Relation of coronary vulnerable plaque instability to serum levels of C-reactive protein and B-type natriuretic peptide in ACS.

Objective To explore the relationship between coronary vulnerable plaque instability and serum C-reactive protein(CRP) , B-type natriuretic peptide(BNP) levels in 85 patients with coronary heart disease. Methods Eighty-five patients( aged 63±16,M= 52 ) were divided into two groups.The control group was 28 patients with stable angina pectoris (SAP). The study group was 57 patients with acute coronary syndrome (ACS) .which were further divided into 21 patients with non ST elevated myocardial infarction (NSTEMI) and 36 patients with unstable angina pectoris (UAP). Plasma BNP and CRP were measured as well as coronary angiography made for all 85 patients. Plaques of coronary culprit arteries were classified as I -III three types according to Ambrose classification. Results (1). BNP and CRP levels of NSTEMI and UAP groups were significant higher than in SAP group. (2).The levels of BNP and CRP correlated with Ambrose classification, especially positively with Ambrose II type ,but no relation with coronary narosis. (3). The levels of BNP was much higher in patients of left anterior descending or multiple coronary artery diseases .(4). The Plaques of coronary culprit arteries in high risk of NSTEMI and UAP patients were mostly Ambrose II or III type. Conclusions The prevalence of higher levels of plasma BNP and CRP in patients with ACS ,when compared with those of SAP, was associated with the instability of coronary vulnerable plaques (ie, Ambrose II type). The level of BNP was much higher in patients of left anterior descending or multiple complicated coronary diseases. So, BNP and CRP are not only markers of vulnerable plaques, but also indicators of ACS prognosis.

Clinical effect of long term aerobic exercise combined with Ginkgo Biloba Leaves Extract Tablets in the treatment of arteriosclerosis

Objective: To investigate the clinical effect of long-term aerobic exercise combined with Ginkgo biloba leaves on atherosclerosis. Methods: 104 patients with carotid atherosclerosis admitted to the Affiliated Hospital of Xi'an Medical College from January 2016 to January 2018 were randomly divided into exercise training group and control group, 52 cases in each group. The control group was treated with Ginkgo biloba leaves, and the exercise training group was treated with long-term aerobic exercise combined with Ginkgo biloba leaves. Both groups were treated for 6 months. The therapeutic effects of the two groups were compared. Results: After treatment, the levels of TC, TG and LDL-C in the two groups were lower than those before treatment, and the levels of HDL-C were higher than those before treatment (P<0.05);after treatment, the levels of TC, TG and LDL-C in the exercise training group were lower than those in the control group, and the levels of HDL-C were higher than those in the control group, with significant difference between the two groups (P<0.05). After treatment, the CIM T and plaque area of the two groups were smaller than those before treatment, and the blood velocity of cerebral artery was higher than that before treatment (P<0.05);after treatment, the CIM T and plaque area of the exercise training group were smaller than those of the control group, and the blood velocity of left middle cerebral artery, right middle cerebral artery and basilar artery were higher than those of the control group. The difference was statistically significant (P<0.05). Conclusion: Long-term aerobic exercise combined with Ginkgo biloba leaf therapy can effectively reduce the blood lipid concentration in patients with carotid atherosclerosis and improve cerebral blood supply.

Molecular imaging of plaques in coronary arteries with PET and SPECT

Coronary artery disease remains a major cause of mortality. Presence of atherosclerotic plaques in the coronary artery is responsible for lu-men stenosis which is often used as an indicator for determining the severity of coronary artery disease. However, the degree of coronary lumen stenosis is not often related to compromising myocardial blood flow, as most of the cardiac events that are caused by atherosclerotic plaques are the result of vulnerable plaques which are prone to rupture. Thus, identification of vulnerable plaques in coronary arteries has become increas-ingly important to assist identify patients with high cardiovascular risks. Molecular imaging with use of positron emission tomography （PET） and single photon emission computed tomography （SPECT） has fulfilled this goal by providing functional information about plaque activity which enables accurate assessment of plaque stability. This review article provides an overview of diagnostic applications of molecular imaging tech-niques in the detection of plaques in coronary arteries with PET and SPECT. New radiopharmaceuticals used in the molecular imaging of coro-nary plaques and diagnostic applications of integrated PET/CT and PET/MRI in coronary plaques are also discussed.

A comparative study of coronary angiography and optical coherence tomography findings in coronary artery disease patients with moderate stenosis

Objective To compare coronary angiography(CAG) and optical coherence tomography(OCT) findings in stenosis and culprit lesion morphology assessment in coronary artery disease patients with moderate stenosis(50%～70%).Methods 23 CAD patients with moderate stenosis(50%～70%) were enrolled in the study.These patients then underwent OCT analysis.CAG and OCT stenosis results were compared for conformity.OCT images of the culprit lesions were analyzed for more details about the morphological characteristics of the plaques in relation with the clinical diagnosis.Results Evaluation of stenosis of coronary lesions by Quantitative Coronary Angiography(QCA) corresponds approximately with OCT analysis estimation:CAG stenosis was 57.26% ±5.05,whereas the same OCT stenosis analysis reached a value of 61.17%±11.36,(P=0.032).From OCT image analysis,the vulnerable plaque was detected more in the culprit lesions of patients with a clinical diagnosis of unstable angina,than in stable angina pectoris patients(61.5%vs10%;P=0.012).

Machine learning for diagnosis of coronary artery disease in computed tomography angiography:A survey

Coronary artery disease(CAD)has become a major illness endangering human health.It mainly manifests as atherosclerotic plaques,especially vulnerable plaques without obvious symptoms in the early stage.Once a rupture occurs,it will lead to severe coronary stenosis,which in turn may trigger a major adverse cardiovascular event.Computed tomography angiography(CTA)has become a standard diagnostic tool for early screening of coronary plaque and stenosis due to its advantages in high resolution,noninvasiveness,and three-dimensional imaging.However,manual examination of CTA images by radiologists has been proven to be tedious and time-consuming,which might also lead to intra-and interobserver errors.Nowadays,many machine learning algorithms have enabled the(semi-)automatic diagnosis of CAD by extracting quantitative features from CTA images.This paper provides a survey of these machine learning algorithms for the diagnosis of CAD in CTA images,including coronary artery extraction,coronary plaque detection,vulnerable plaque identification,and coronary stenosis assessment.Most included articles were published within this decade and are found in the Web of Science.We wish to give readers a glimpse of the current status,challenges,and perspectives of these machine learning-based analysis methods for automatic CAD diagnosis.