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.Základní údaje
Originální název
Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography
Autoři
JACKSON, Robert (826 Velká Británie a Severní Irsko), Abtehale AL-HUSSAINI (826 Velká Británie a Severní Irsko), Shiju JOSEPH (826 Velká Británie a Severní Irsko), Gijs VAN SOEST (528 Nizozemské království), Alice WOOD (826 Velká Británie a Severní Irsko), Fernando MACAYA (724 Španělsko), Nieves GONZALO (724 Španělsko), Jamil CADE (76 Brazílie), Adriano CAIXETA (76 Brazílie), Ota HLINOMAZ (203 Česká republika, domácí), Pavel LEINVEBER (203 Česká republika, domácí), Peter O KANE (826 Velká Británie a Severní Irsko), Marcos GARCIA-GUIMARAES (724 Španělsko), Bernardo CORTESE (380 Itálie), Nilesh J. SAMANI (826 Velká Británie a Severní Irsko), Javier ESCANED (724 Španělsko), Fernando ALFONSO (724 Španělsko), Thomas JOHNSON (826 Velká Británie a Severní Irsko) a David ADLAM (826 Velká Británie a Severní Irsko, garant)
Vydání
JACC-CARDIOVASCULAR IMAGING, NEW YORK, ELSEVIER SCIENCE INC, 2019, 1936-878X
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30201 Cardiac and Cardiovascular systems
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 12.740
Kód RIV
RIV/00216224:14110/19:00113020
Organizační jednotka
Lékařská fakulta
UT WoS
000500693700015
Klíčová slova anglicky
intracoronary imaging; optical coherence tomography; spontaneous coronary artery dissection
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 11. 3. 2020 14:24, Mgr. Tereza Miškechová
Anotace
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.