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Journal of Nuclear Cardiology
Erschienen in: Journal of Nuclear Cardiology 3/2018

01.06.2018 | Review Article

Invasive assessment of coronary artery disease

verfasst von: Stylianos A. Pyxaras, MD, William Wijns, MD, PhD, Johan H. C. Reiber, PhD, Jeroen J. Bax, MD, PhD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 3/2018

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Abstract

Coronary artery disease is associated to high mortality and morbidity rates and an accurate diagnostic assessment during heart catheterization has a fundamental role in prognostic stratification and treatment choices. Coronary angiography has been integrated by intravascular imaging modalities, namely intravascular ultrasound and optical coherence tomography, which allow the precise quantification of the atherosclerotic burden of coronary arteries. The hemodynamic relevance of a given coronary stenosis can be assessed using stress or resting indexes: fractional flow reserve and instantaneous wave-free ratio are both coronary flow surrogates, used to guide percutaneous coronary interventions. This review summarizes the current state-of-the-art of invasive diagnostic methods during heart catheterization and highlights the potential role that an integration of anatomical and functional information enables.
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Literatur
1.
Mintz GS, Weissman NJ. Intravascular ultrasound in the drug-eluting stent era. J Am Coll Cardiol 2006;48:421-9.CrossRefPubMed
2.
Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol 2012;59:1058-72.CrossRefPubMed
3.
De Bruyne B, Pijls NH, Kalesan B, Barbato E, Tonino PA, Piroth Z, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med 2012;367:991-1001.CrossRefPubMed
4.
Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F, van' t Veer M, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med 2009;360:213-24.CrossRefPubMed
5.
Kolh P, Windecker S, Alfonso F, Collet JP, Cremer J, Falk V, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur J Cardiothorac Surg 2014;46:517-92.CrossRefPubMed
6.
Stadius ML, Alderman EL. Coronary artery revascularization. Critical need for, and consequences of, objective angiographic assessment of lesion severity. Circulation 1990;82:2231-4.CrossRefPubMed
7.
Berry C, L’Allier PL, Gregoire J, Lesperance J, Levesque S, Ibrahim R, et al. Comparison of intravascular ultrasound and quantitative coronary angiography for the assessment of coronary artery disease progression. Circulation 2007;115:1851-7.CrossRefPubMed
8.
Nallamothu BK, Spertus JA, Lansky AJ, Cohen DJ, Jones PG, Kureshi F, et al. Comparison of clinical interpretation with visual assessment and quantitative coronary angiography in patients undergoing percutaneous coronary intervention in contemporary practice: The Assessing Angiography (A2) project. Circulation 2013;127:1793-800.CrossRefPubMedPubMedCentral
9.
Grundeken MJ, Ishibashi Y, Ramcharitar S, Tuinenburg JC, Reiber JH, Tu S, et al. The need for dedicated bifurcation quantitative coronary angiography (QCA) software algorithms to evaluate bifurcation lesions. EuroIntervention 2015;11 Suppl V:V44-9.
10.
Grundeken MJ, Ishibashi Y, Genereux P, LaSalle L, Iqbal J, Wykrzykowska JJ, et al. Inter-core lab variability in analyzing quantitative coronary angiography for bifurcation lesions: A post-hoc analysis of a randomized trial. JACC Cardiovasc Interv 2015;8:305-14.CrossRefPubMed
11.
Pyxaras SA, Tu S, Barbato E, Barbati G, Di Serafino L, De Vroey F, et al. Quantitative angiography and optical coherence tomography for the functional assessment of nonobstructive coronary stenoses: Comparison with fractional flow reserve. Am Heart J 2013;166:1010-8.CrossRefPubMed
12.
Sanidas E, Dangas G. Evolution of intravascular assessment of coronary anatomy and physiology: From ultrasound imaging to optical and flow assessment. Eur J Clin Invest 2013;43:996-1008.CrossRefPubMed
13.
Mintz GS. Clinical utility of intravascular imaging and physiology in coronary artery disease. J Am Coll Cardiol 2014;64:207-22.CrossRefPubMed
14.
Oviedo C, Maehara A, Mintz GS, Araki H, Choi SY, Tsujita K, et al. Intravascular ultrasound classification of plaque distribution in left main coronary artery bifurcations: Where is the plaque really located? Circ Cardiovasc Interv 2010;3:105-12.CrossRefPubMed
15.
de la Torre Hernandez JM, Hernandez Hernandez F, Alfonso F, Rumoroso JR, Lopez-Palop R, Sadaba M, et al. Prospective application of pre-defined intravascular ultrasound criteria for assessment of intermediate left main coronary artery lesions results from the multicenter LITRO study. J Am Coll Cardiol 2011;58:351-8.CrossRefPubMed
16.
Hamilos M, Muller O, Cuisset T, Ntalianis A, Chlouverakis G, Sarno G, et al. Long-term clinical outcome after fractional flow reserve-guided treatment in patients with angiographically equivocal left main coronary artery stenosis. Circulation 2009;120:1505-12.CrossRefPubMed
17.
Jasti V, Ivan E, Yalamanchili V, Wongpraparut N, Leesar MA. Correlations between fractional flow reserve and intravascular ultrasound in patients with an ambiguous left main coronary artery stenosis. Circulation 2004;110:2831-6.CrossRefPubMed
18.
Rathore S, Katoh O, Tuschikane E, Oida A, Suzuki T, Takase S. A novel modification of the retrograde approach for the recanalization of chronic total occlusion of the coronary arteries intravascular ultrasound-guided reverse controlled antegrade and retrograde tracking. JACC Cardiovasc Interv 2010;3:155-64.CrossRefPubMed
19.
Zhang Y, Farooq V, Garcia-Garcia HM, Bourantas CV, Tian N, Dong S, et al. Comparison of intravascular ultrasound versus angiography-guided drug-eluting stent implantation: A meta-analysis of one randomised trial and ten observational studies involving 19,619 patients. EuroIntervention 2012;8:855-65.CrossRefPubMed
20.
Klersy C, Ferlini M, Raisaro A, Scotti V, Balduini A, Curti M, et al. Use of IVUS guided coronary stenting with drug eluting stent: A systematic review and meta-analysis of randomized controlled clinical trials and high quality observational studies. Int J Cardiol 2013;170:54-63.CrossRefPubMed
21.
Jang JS, Song YJ, Kang W, Jin HY, Seo JS, Yang TH, et al. Intravascular ultrasound-guided implantation of drug-eluting stents to improve outcome: A meta-analysis. JACC Cardiovasc Interv 2014;7:233-43.CrossRefPubMed
22.
Ahn JM, Kang SJ, Yoon SH, Park HW, Kang SM, Lee JY, et al. Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies. Am J Cardiol 2014;113:1338-47.CrossRefPubMed
23.
Claessen BE, Maehara A, Fahy M, Xu K, Stone GW, Mintz GS. Plaque composition by intravascular ultrasound and distal embolization after percutaneous coronary intervention. JACC Cardiovasc Imaging 2012;5:S111-8.CrossRefPubMed
24.
Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med 2011;364:226-35.CrossRefPubMed
25.
Calvert PA, Obaid DR, O’Sullivan M, Shapiro LM, McNab D, Densem CG, et al. Association between IVUS findings and adverse outcomes in patients with coronary artery disease: The VIVA (VH-IVUS in Vulnerable Atherosclerosis) Study. JACC Cardiovasc Imaging 2011;4:894-901.CrossRefPubMed
26.
Cheng JM, Garcia-Garcia HM, de Boer SP, Kardys I, Heo JH, Akkerhuis KM, et al. In vivo detection of high-risk coronary plaques by radiofrequency intravascular ultrasound and cardiovascular outcome: results of the ATHEROREMO-IVUS study. Eur Heart J 2014;35:639-47.CrossRefPubMed
27.
Serruys PW, Garcia-Garcia HM, Buszman P, Erne P, Verheye S, Aschermann M, et al. Effects of the direct lipoprotein-associated phospholipase A(2) inhibitor darapladib on human coronary atherosclerotic plaque. Circulation 2008;118:1172-82.CrossRefPubMed
28.
Prati F, Guagliumi G, Mintz GS, Costa M, Regar E, Akasaka T, et al. Expert review document part 2: Methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures. Eur Heart J 2012;33:2513-20.CrossRefPubMedPubMedCentral
29.
Onuma Y, Thuesen L, van Geuns RJ, van der Ent M, Desch S, Fajadet J, et al. Randomized study to assess the effect of thrombus aspiration on flow area in patients with ST-elevation myocardial infarction: An optical frequency domain imaging study-TROFI trial. Eur Heart J 2013;34:1050-60.CrossRefPubMed
30.
Sinclair H, Bourantas C, Bagnall A, Mintz GS, Kunadian V. OCT for the identification of vulnerable plaque in acute coronary syndrome. JACC Cardiovasc Imaging 2015;8:198-209.CrossRefPubMed
31.
Uemura S, Ishigami K, Soeda T, Okayama S, Sung JH, Nakagawa H, et al. Thin-cap fibroatheroma and microchannel findings in optical coherence tomography correlate with subsequent progression of coronary atheromatous plaques. Eur Heart J 2012;33:78-85.CrossRefPubMed
32.
Tian J, Ren X, Vergallo R, Xing L, Yu H, Jia H, et al. Distinct morphological features of ruptured culprit plaque for acute coronary events compared to those with silent rupture and thin-cap fibroatheroma: A combined optical coherence tomography and intravascular ultrasound study. J Am Coll Cardiol 2014;63:2209-16.CrossRefPubMed
33.
Prati F, Di Vito L, Biondi-Zoccai G, Occhipinti M, La Manna A, Tamburino C, et al. Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: The Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study. EuroIntervention 2012;8:823-9.CrossRefPubMed
34.
Gomez-Lara J, Radu M, Brugaletta S, Farooq V, Diletti R, Onuma Y, et al. Serial analysis of the malapposed and uncovered struts of the new generation of everolimus-eluting bioresorbable scaffold with optical coherence tomography. JACC Cardiovasc Interv 2011;4:992-1001.CrossRefPubMed
35.
Mattesini A, Secco GG, Dall’Ara G, Ghione M, Rama-Merchan JC, Lupi A, et al. ABSORB biodegradable stents versus second-generation metal stents: A comparison study of 100 complex lesions treated under OCT guidance. JACC Cardiovasc Interv 2014;7:741-50.CrossRefPubMed
36.
Wijns W, Shite J, Jones MR, Lee SW, Price MJ, Fabbiocchi F, et al. Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I study. Eur Heart J 2015;36:3346-55.CrossRefPubMedPubMedCentral
37.
Maehara A, Ben-Yehuda O, Ali Z, Wijns W, Bezerra HG, Shite J, et al. Comparison of stent expansion guided by optical coherence tomography versus intravascular ultrasound: The ILUMIEN II Study (Observational Study of Optical Coherence Tomography [OCT] in Patients Undergoing Fractional Flow Reserve [FFR] and Percutaneous Coronary Intervention). JACC Cardiovasc Interv 2015;8:1704-14.CrossRefPubMed
38.
Farooq V, Gogas BD, Okamura T, Heo JH, Magro M, Gomez-Lara J, et al. Three-dimensional optical frequency domain imaging in conventional percutaneous coronary intervention: The potential for clinical application. Eur Heart J 2013;34:875-85.CrossRefPubMed
39.
Okamura T, Onuma Y, Garcia-Garcia HM, Regar E, Wykrzykowska JJ, Koolen J, et al. 3-Dimensional optical coherence tomography assessment of jailed side branches by bioresorbable vascular scaffolds: a proposal for classification. JACC Cardiovasc Interv 2010;3:836-44.CrossRefPubMed
40.
Okamura T, Onuma Y, Yamada J, Iqbal J, Tateishi H, Nao T, et al. 3D optical coherence tomography: New insights into the process of optimal rewiring of side branches during bifurcational stenting. EuroIntervention 2014;10:907-15.CrossRefPubMed
41.
Pijls NH, van Son JA, Kirkeeide RL, De Bruyne B, Gould KL. Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty. Circulation 1993;87:1354-67.CrossRefPubMed
42.
Task Force on Myocardial Revascularization of the European Society of C, the European Association for Cardio-Thoracic S, European Association for Percutaneous Cardiovascular I, Wijns W, Kolh P, Danchin N, et al. Guidelines on myocardial revascularization. Eur Heart J 2010;31:2501-55.CrossRef
43.
Adjedj J, Toth GG, Johnson NP, Pellicano M, Ferrara A, Flore V, et al. Intracoronary adenosine: Dose-response relationship with hyperemia. JACC Cardiovasc Interv 2015;8:1422-30.CrossRefPubMed
44.
Pijls NH, van Schaardenburgh P, Manoharan G, Boersma E, Bech JW, van't Veer M, et al. Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study. J Am Coll Cardiol 2007;49:2105-11.CrossRefPubMed
45.
Toth G, De Bruyne B, Casselman F, De Vroey F, Pyxaras S, Di Serafino L, et al. Fractional flow reserve-guided versus angiography-guided coronary artery bypass graft surgery. Circulation 2013;128:1405-11.CrossRefPubMed
46.
Layland J, Oldroyd KG, Curzen N, Sood A, Balachandran K, Das R, et al. Fractional flow reserve vs angiography in guiding management to optimize outcomes in non-ST-segment elevation myocardial infarction: The British Heart Foundation FAMOUS-NSTEMI randomized trial. Eur Heart J 2015;36:100-11.CrossRefPubMed
47.
Fearon WF, Balsam LB, Farouque HM, Caffarelli AD, Robbins RC, Fitzgerald PJ, et al. Novel index for invasively assessing the coronary microcirculation. Circulation 2003;107:3129-32.CrossRefPubMed
48.
De Bruyne B, Pijls NH, Smith L, Wievegg M, Heyndrickx GR. Coronary thermodilution to assess flow reserve: Experimental validation. Circulation 2001;104:2003-6.CrossRefPubMed
49.
Pijls NH, De Bruyne B, Smith L, Aarnoudse W, Barbato E, Bartunek J, et al. Coronary thermodilution to assess flow reserve: Validation in humans. Circulation 2002;105:2482-6.CrossRefPubMed
50.
Aarnoudse W, Fearon WF, Manoharan G, Geven M, van de Vosse F, Rutten M, et al. Epicardial stenosis severity does not affect minimal microcirculatory resistance. Circulation 2004;110:2137-42.CrossRefPubMed
51.
Fearon WF, Low AF, Yong AS, McGeoch R, Berry C, Shah MG, et al. Prognostic value of the Index of Microcirculatory Resistance measured after primary percutaneous coronary intervention. Circulation 2013;127:2436-41.CrossRefPubMedPubMedCentral
52.
Cuculi F, De Maria GL, Meier P, Dall'Armellina E, de Caterina AR, Channon KM, et al. Impact of microvascular obstruction on the assessment of coronary flow reserve, index of microcirculatory resistance, and fractional flow reserve after ST-segment elevation myocardial infarction. J Am Coll Cardiol 2014;64:1894-904.CrossRefPubMed
53.
Sen S, Escaned J, Malik IS, Mikhail GW, Foale RA, Mila R, et al. Development and validation of a new adenosine-independent index of stenosis severity from coronary wave-intensity analysis: results of the ADVISE (ADenosine Vasodilator Independent Stenosis Evaluation) study. J Am Coll Cardiol 2012;59:1392-402.CrossRefPubMed
54.
Berry C, van ‘t Veer M, Witt N, Kala P, Bocek O, Pyxaras SA, et al. VERIFY (VERification of Instantaneous Wave-Free Ratio and Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis Severity in EverydaY Practice): A multicenter study in consecutive patients. J Am Coll Cardiol 2013;61:1421-7.CrossRefPubMed
55.
Jeremias A, Maehara A, Genereux P, Asrress KN, Berry C, De Bruyne B, et al. Multicenter core laboratory comparison of the instantaneous wave-free ratio and resting Pd/Pa with fractional flow reserve: the RESOLVE study. J Am Coll Cardiol 2014;63:1253-61.CrossRefPubMed
56.
Davies JE, Sen S, Dehbi HM, Al-Lamee R, Petraco R, Nijjer SS, et al. Use of the instantaneous wave-free ratio or fractional flow reserve in PCI. N Engl J Med 2017;376:1824-34.CrossRefPubMed
57.
Gotberg M, Christiansen EH, Gudmundsdottir IJ, Sandhall L, Danielewicz M, Jakobsen L, et al. Instantaneous wave-free ratio versus fractional flow reserve to guide PCI. N Engl J Med 2017;376:1813-23.CrossRefPubMed
58.
Leone AM, Scalone G, De Maria GL, Tagliaferro F, Gardi A, Clemente F, et al. Efficacy of contrast medium induced Pd/Pa ratio in predicting functional significance of intermediate coronary artery stenosis assessed by fractional flow reserve: Insights from the RINASCI study. EuroIntervention 2015;11:421-7.CrossRefPubMed
59.
Tu S, Barbato E, Koszegi Z, Yang J, Sun Z, Holm NR, et al. Fractional flow reserve calculation from 3-dimensional quantitative coronary angiography and TIMI frame count: A fast computer model to quantify the functional significance of moderately obstructed coronary arteries. JACC Cardiovasc Interv 2014;7:768-77.CrossRefPubMed
60.
Task Force M, Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, et al. 2013 ESC guidelines on the management of stable coronary artery disease: The task force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013;34:2949-3003.CrossRef
61.
Gould KL, Lipscomb K. Effects of coronary stenoses on coronary flow reserve and resistance. Am J Cardiol 1974;34:48-55.CrossRefPubMed
62.
Toth G, Hamilos M, Pyxaras S, Mangiacapra F, Nelis O, De Vroey F, et al. Evolving concepts of angiogram: Fractional flow reserve discordances in 4000 coronary stenoses. Eur Heart J 2014;35:2831-8.CrossRefPubMed
63.
Fischer JJ, Samady H, McPherson JA, Sarembock IJ, Powers ER, Gimple LW, et al. Comparison between visual assessment and quantitative angiography versus fractional flow reserve for native coronary narrowings of moderate severity. Am J Cardiol 2002;90:210-5.CrossRefPubMed
64.
Yong AS, Ng AC, Brieger D, Lowe HC, Ng MK, Kritharides L. Three-dimensional and two-dimensional quantitative coronary angiography, and their prediction of reduced fractional flow reserve. Eur Heart J 2011;32:345-53.CrossRefPubMed
65.
Saad M, Toelg R, Khattab AA, Kassner G, Abdel-Wahab M, Richardt G. Determination of haemodynamic significance of intermediate coronary lesions using three-dimensional coronary reconstruction. EuroIntervention 2009;5:573-9.CrossRefPubMed
66.
Takagi A, Tsurumi Y, Ishii Y, Suzuki K, Kawana M, Kasanuki H. Clinical potential of intravascular ultrasound for physiological assessment of coronary stenosis: Relationship between quantitative ultrasound tomography and pressure-derived fractional flow reserve. Circulation 1999;100:250-5.CrossRefPubMed
67.
Puri R, Kapadia SR, Nicholls SJ, Harvey JE, Kataoka Y, Tuzcu EM. Optimizing outcomes during left main percutaneous coronary intervention with intravascular ultrasound and fractional flow reserve: The current state of evidence. JACC Cardiovasc Interv 2012;5:697-707.CrossRefPubMed
68.
Gonzalo N, Escaned J, Alfonso F, Nolte C, Rodriguez V, Jimenez-Quevedo P, et al. Morphometric assessment of coronary stenosis relevance with optical coherence tomography: A comparison with fractional flow reserve and intravascular ultrasound. J Am Coll Cardiol 2012;59:1080-9.CrossRefPubMed
69.
Shiono Y, Kitabata H, Kubo T, Masuno T, Ohta S, Ozaki Y, et al. Optical coherence tomography-derived anatomical criteria for functionally significant coronary stenosis assessed by fractional flow reserve. Circ J 2012;76:2218-25.CrossRefPubMed
Metadaten
Titel
Invasive assessment of coronary artery disease
verfasst von
Stylianos A. Pyxaras, MD
William Wijns, MD, PhD
Johan H. C. Reiber, PhD
Jeroen J. Bax, MD, PhD
Publikationsdatum
01.06.2018
Verlag
Springer US
Erschienen in
Journal of Nuclear Cardiology / Ausgabe 3/2018
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-017-1050-5

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