J 2019

Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography

JACKSON, Robert, Abtehale AL-HUSSAINI, Shiju JOSEPH, Gijs VAN SOEST, Alice WOOD et. al.

Basic information

Original name

Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography

Authors

JACKSON, Robert (826 United Kingdom of Great Britain and Northern Ireland), Abtehale AL-HUSSAINI (826 United Kingdom of Great Britain and Northern Ireland), Shiju JOSEPH (826 United Kingdom of Great Britain and Northern Ireland), Gijs VAN SOEST (528 Netherlands), Alice WOOD (826 United Kingdom of Great Britain and Northern Ireland), Fernando MACAYA (724 Spain), Nieves GONZALO (724 Spain), Jamil CADE (76 Brazil), Adriano CAIXETA (76 Brazil), Ota HLINOMAZ (203 Czech Republic, belonging to the institution), Pavel LEINVEBER (203 Czech Republic, belonging to the institution), Peter O KANE (826 United Kingdom of Great Britain and Northern Ireland), Marcos GARCIA-GUIMARAES (724 Spain), Bernardo CORTESE (380 Italy), Nilesh J. SAMANI (826 United Kingdom of Great Britain and Northern Ireland), Javier ESCANED (724 Spain), Fernando ALFONSO (724 Spain), Thomas JOHNSON (826 United Kingdom of Great Britain and Northern Ireland) and David ADLAM (826 United Kingdom of Great Britain and Northern Ireland, guarantor)

Edition

JACC-CARDIOVASCULAR IMAGING, NEW YORK, ELSEVIER SCIENCE INC, 2019, 1936-878X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 12.740

RIV identification code

RIV/00216224:14110/19:00113020

Organization unit

Faculty of Medicine

DOI

UT WoS

000500693700015

Keywords in English

intracoronary imaging; optical coherence tomography; spontaneous coronary artery dissection

Tags

Tags

International impact, Reviewed
Změněno: 11/3/2020 14:24, Mgr. Tereza Miškechová

Abstract

V originále

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.