| JACKSON, Robert, Abtehale AL-HUSSAINI, Shiju JOSEPH, Gijs VAN SOEST, Alice WOOD, Fernando MACAYA, Nieves GONZALO, Jamil CADE, Adriano CAIXETA, Ota HLINOMAZ, Pavel LEINVEBER, Peter O KANE, Marcos GARCIA-GUIMARAES, Bernardo CORTESE, Nilesh J. SAMANI, Javier ESCANED, Fernando ALFONSO, Thomas JOHNSON a David ADLAM. Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography. JACC-CARDIOVASCULAR IMAGING. NEW YORK: ELSEVIER SCIENCE INC, 2019, roč. 12, č. 12, s. 2475-2488. ISSN 1936-878X. Dostupné z: https://dx.doi.org/10.1016/j.jcmg.2019.01.015. |
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@article{1625796,
author = {Jackson, Robert and AlandHussaini, Abtehale and Joseph, Shiju and van Soest, Gijs and Wood, Alice and Macaya, Fernando and Gonzalo, Nieves and Cade, Jamil and Caixeta, Adriano and Hlinomaz, Ota and Leinveber, Pavel and O Kane, Peter and GarciaandGuimaraes, Marcos and Cortese, Bernardo and Samani, Nilesh J. and Escaned, Javier and Alfonso, Fernando and Johnson, Thomas and Adlam, David},
article_location = {NEW YORK},
article_number = {12},
doi = {http://dx.doi.org/10.1016/j.jcmg.2019.01.015},
keywords = {intracoronary imaging; optical coherence tomography; spontaneous coronary artery dissection},
language = {eng},
issn = {1936-878X},
journal = {JACC-CARDIOVASCULAR IMAGING},
title = {Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography},
url = {http://dx.doi.org/10.1016/j.jcmg.2019.01.015},
volume = {12},
year = {2019}
}
TY - JOUR
ID - 1625796
AU - Jackson, Robert - Al-Hussaini, Abtehale - Joseph, Shiju - van Soest, Gijs - Wood, Alice - Macaya, Fernando - Gonzalo, Nieves - Cade, Jamil - Caixeta, Adriano - Hlinomaz, Ota - Leinveber, Pavel - O Kane, Peter - Garcia-Guimaraes, Marcos - Cortese, Bernardo - Samani, Nilesh J. - Escaned, Javier - Alfonso, Fernando - Johnson, Thomas - Adlam, David
PY - 2019
TI - Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography
JF - JACC-CARDIOVASCULAR IMAGING
VL - 12
IS - 12
SP - 2475-2488
EP - 2475-2488
PB - ELSEVIER SCIENCE INC
SN - 1936878X
KW - intracoronary imaging
KW - optical coherence tomography
KW - spontaneous coronary artery dissection
UR - http://dx.doi.org/10.1016/j.jcmg.2019.01.015
L2 - http://dx.doi.org/10.1016/j.jcmg.2019.01.015
N2 - OBJECTIVES This study used optical coherence tomography to investigate the mechanism of false lumen (FL) formation in spontaneous coronary artery dissection (SCAD) by studying: 1) differences between fenestrated and nonfenestrated SCAD; 2) vasa vasorum density; and 3) light attenuation characteristics of the FL. BACKGROUND SCAD is an increasingly recognized cause of acute coronary syndromes, characterized by FL formation and compression of the true lumen (TL). The mechanisms underlying FL formation remain poorly understood. METHODS A total of 65 SCAD patients (68 vessels) who underwent acute OCT imaging as part of routine clinical care were included. Images were classified by the absence or presence of a connection (fenestration) between the TL and FL. Indexed measurements of TL stenosis, external elastic lamina (EEL) area, FL area, and light attenuation of the FL were assessed. Vasa vasorum densities of SCAD cases were compared with those in control non-SCAD myocardial infarction cases. RESULTS In nonfenestrated cases, there was significantly larger expansion of the EEL area (9.1% vs. -1.9%; p<0.05) and a larger FL area (73.6% vs. 53.2%, respectively; p<0.05) in dissected segments. No significant differences were found between vasa vasorum density in SCAD and those in control subjects. The FL contents were heterogeneous but attenuated less light than whole blood or thrombus (4.28 +/- 0.55 mm(-1) vs. 5.08 +/- 0.56 mm(-1); p < 0.05; vs. 4.96 +/- 0.56 mm(-1); p < 0.05). CONCLUSIONS These observational data suggest that the absence of a fenestration leads to increased FL pressure and compression of the TL. Although vasa vasorum may still be implicated in pathogenesis, increased vasa vasorum density could be an epiphenomenon of vascular healing. (C) 2019 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved.
ER -
JACKSON, Robert, Abtehale AL-HUSSAINI, Shiju JOSEPH, Gijs VAN SOEST, Alice WOOD, Fernando MACAYA, Nieves GONZALO, Jamil CADE, Adriano CAIXETA, Ota HLINOMAZ, Pavel LEINVEBER, Peter O KANE, Marcos GARCIA-GUIMARAES, Bernardo CORTESE, Nilesh J. SAMANI, Javier ESCANED, Fernando ALFONSO, Thomas JOHNSON a David ADLAM. Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography. \textit{JACC-CARDIOVASCULAR IMAGING}. NEW YORK: ELSEVIER SCIENCE INC, 2019, roč.~12, č.~12, s.~2475-2488. ISSN~1936-878X. Dostupné z: https://dx.doi.org/10.1016/j.jcmg.2019.01.015.
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