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Diagnostics
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Diagnosis and Treatment of Coronary Artery Disease: Moving toward the...
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Diagnosis and Treatment of Coronary Artery Disease: Moving toward the Future

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (29 December 2023) | Viewed by 6793

Special Issue Editors

Dr. Carlos Collet

E-Mail Website
Guest Editor
Cardiovascular Center Aalst, Onze Lieve Vrouw Hospital, Aalst, Belgium
Interests: interventional cardiology
Dr. Frédéric Bouisset

E-Mail
Guest Editor
Department of Cardiology, Toulouse Rangueil University Hospital, UMR 1295 INSERM, Hôpital Rangueil, CHU Toulouse, Toulouse, France
Interests: cardiogenic shock; percutaneous left ventricle assist device; mortality; acute coronary syndrome; prognosis
Dr. Koshiro Sakai

E-Mail Website
Guest Editor
Division of Cardiology, Department of Medicine, Showa, University School of Medicine, Tokyo, Japan
Interests: cardiovascular catheterization

Special Issue Information

Dear Colleagues, 

Remarkable progress in the field of coronary artery disease has been made in recent years, both in understanding the pathophysiology of the disease itself, and in its management, thanks to new diagnostic and therapeutic tools.

However, this process is ongoing. We are seeing emerging concepts, new tools, and new drugs, allowing us to better comprehend and treat coronary artery disease.

In this Special Issue of Diagnostics entitled “Diagnosis and Treatment of Coronary Artery Disease: Moving toward the Future”, we wish to give authors the opportunity to develop these concepts in detail to present what the cardiology of tomorrow will be, in terms of CAD diagnosis and management.

We welcome original articles and reviews focusing on the following:

  • The role of coronary CT as an adjunctive tool to diagnostic angiography for revascularization guidance;
  • All new modalities in imaging and coronary physiology in the field of coronary artery disease, both epicardial and microvascular;
  • Robotics-assisted PCI and robotics-assisted CABG surgery;
  • New therapeutics in STEMI management in the cath lab;
  • New mechanical supports for cardiogenic shock and high-risk PCI;
  • Next steps in terms of chronic treatment, especially antiplatelet and lipid-lowering therapy;
  • New insights in the field of cellular therapy;
  • Projections in epidemiology for the coming decades.

Contributions may be related to these topics and should expand on the knowledge surrounding such topics.

Dr. Carlos Collet
Dr. Frédéric Bouisset
Dr. Koshiro Sakai
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Published Papers (6 papers)

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Research

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13 pages, 277 KiB  
Article
Could Tumor Necrosis Factor Serve as a Marker for Cardiovascular Risk Factors and Left Ventricular Hypertrophy in Patients with Early-Onset Coronary Artery Disease?
by Marta Białecka, Violetta Dziedziejko, Krzysztof Safranow, Andrzej Krzystolik, Zuzanna Marcinowska, Dariusz Chlubek and Monika Rać
Diagnostics 2024, 14(4), 449; https://doi.org/10.3390/diagnostics14040449 - 18 Feb 2024
Cited by 1 | Viewed by 882
Abstract
Introduction: Tumor necrosis factor (TNF), a pro-inflammatory cytokine, can be produced by cardiomyocytes, leading to metabolic disorders in the myocardium. The objective of this study was to assess the relationship between plasma levels of the TNF cytokine and the presence of known biochemical [...] Read more.
Introduction: Tumor necrosis factor (TNF), a pro-inflammatory cytokine, can be produced by cardiomyocytes, leading to metabolic disorders in the myocardium. The objective of this study was to assess the relationship between plasma levels of the TNF cytokine and the presence of known biochemical and clinical risk factors for cardiovascular disease, along with the parameters of cardiac morphology in patients diagnosed with coronary artery disease (CAD) at a young age. Materials and Methods: The study group included 75 men aged up to 50 years and 25 women aged up to 55 years. The plasma TNF concentration was measured by use of the ELISA assay. Echocardiography and electrocardiographic examinations were performed in all patients. Results: We observed positive correlations for TNF with the BMI ratio, weight, waist and hip circumference. We also found negative correlations for TNF with HDL levels and ApoA concentrations, and positive correlations with the ApoB/ApoA1 ratio, Apo B, IL6, LDL and TG concentrations. These results suggest an association between higher plasma TNF concentrations and components of metabolic syndrome, including dyslipidemia. TNF may be a potential risk factor for impaired diastolic function. Conclusions: While TNF may be useful for diagnosing certain risks in CAD patients, the TNF measurement cannot be used as a surrogate test for echocardiography. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Coronary Artery Disease: Moving toward the Future)
12 pages, 2712 KiB  
Article
Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces
by Samer Fawaz, Daniel Munhoz, Thabo Mahendiran, Emanuele Gallinoro, Takuya Mizukami, Sarosh A. Khan, Rupert F. G. Simpson, Johan Svanerud, Christopher M. Cook, John R. Davies, Grigoris V. Karamasis, Bernard De Bruyne and Thomas R. Keeble
Diagnostics 2024, 14(3), 285; https://doi.org/10.3390/diagnostics14030285 - 28 Jan 2024
Viewed by 583
Abstract
Continuous Thermodilution is a novel method of quantifying coronary flow (Q) in mL/min. To account for variability of Q within the cardiac cycle, the trace is smoothened with a 2 s moving average filter. This can sometimes be ineffective due to significant heart [...] Read more.
Continuous Thermodilution is a novel method of quantifying coronary flow (Q) in mL/min. To account for variability of Q within the cardiac cycle, the trace is smoothened with a 2 s moving average filter. This can sometimes be ineffective due to significant heart rate variability, ventricular extrasystoles, and deep inspiration, resulting in a fluctuating temperature trace and ambiguity in the location of the “steady state”. This study aims to assess whether a longer moving average filter would smoothen any fluctuations within the continuous thermodilution traces resulting in improved interpretability and reproducibility on a test–retest basis. Patients with ANOCA underwent repeat continuous thermodilution measurements. Analysis of traces were performed at averages of 10, 15, and 20 s to determine the maximum acceptable average. The maximum acceptable average was subsequently applied as a moving average filter and the traces were re-analysed to assess the practical consequences of a longer moving average. Reproducibility was then assessed and compared to a 2 s moving average. Of the averages tested, only 10 s met the criteria for acceptance. When the data was reanalysed with a 10 s moving average filter, there was no significant improvement in reproducibility, however, it resulted in a 12% diagnostic mismatch. Applying a longer moving average filter to continuous thermodilution data does not improve reproducibility. Furthermore, it results in a loss of fidelity on the traces, and a 12% diagnostic mismatch. Overall, current practice should be maintained. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Coronary Artery Disease: Moving toward the Future)
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11 pages, 633 KiB  
Article
Prognostic Impact of a Routine Six-Month Exercise Stress Test after Complex Left Main Bifurcation Percutaneous Intervention
by Gianluca Rigatelli, Marco Zuin, Giuseppe Marchese, Ervis Hiso, Giulio Rodinò, Loris Roncon and Giampaolo Pasquetto
Diagnostics 2024, 14(1), 59; https://doi.org/10.3390/diagnostics14010059 - 26 Dec 2023
Viewed by 684
Abstract
The prognostic value of exercise stress test after complex left main (LM) coronary artery bifurcation (LM) stenting has been poorly investigated. To partially fill this gap in knowledge, we retrospectively analyzed the procedural and medical data of consecutive patients referred to our center [...] Read more.
The prognostic value of exercise stress test after complex left main (LM) coronary artery bifurcation (LM) stenting has been poorly investigated. To partially fill this gap in knowledge, we retrospectively analyzed the procedural and medical data of consecutive patients referred to our center for complex LM bifurcation disease between January 2008 and May 2018 who were treated using either single- or dual-stenting techniques. The prognostic impact of an exercise stress test, performed 6 months after the coronary intervention, was evaluated in 502 patients (316 males, mean age 70.3 ± 12.8 years, mean Syntax score 31.6 ± 6.3). At follow up after a mean of 37.1 ± 10.8 months (range 22.1–47.3 months), the target lesion failure (TLF) rate was 10.1% while stent thrombosis and cardiovascular mortality were 1.2 and 3.6%, respectively. A positive exercise stress test was detected at 6-month follow up in 42 out of 502 patients (8.4%); the incidence of a significant restenosis was 7.6% (n = 38). Patients with a negative exercise stress test at 6-month follow up had higher freedom from TLF and improved survival compared to those with a positive exercise stress test. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Coronary Artery Disease: Moving toward the Future)
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14 pages, 4231 KiB  
Article
Intravascular Ultrasound vs. Fractional Flow Reserve for Percutaneous Coronary Intervention Optimization in Long Coronary Artery Lesions
by Povilas Budrys, Aaron Peace, Arvydas Baranauskas and Giedrius Davidavicius
Diagnostics 2023, 13(18), 2921; https://doi.org/10.3390/diagnostics13182921 - 12 Sep 2023
Cited by 1 | Viewed by 867
Abstract
Background: intravascular ultrasound (IVUS) and fractional flow reserve (FFR) have both been shown to be superior to angiography in optimizing percutaneous coronary intervention (PCI). However, there is still a lack of comparative studies between PCI optimization using physiology and intravascular imaging head-to-head. The [...] Read more.
Background: intravascular ultrasound (IVUS) and fractional flow reserve (FFR) have both been shown to be superior to angiography in optimizing percutaneous coronary intervention (PCI). However, there is still a lack of comparative studies between PCI optimization using physiology and intravascular imaging head-to-head. The aim of this study was to compare the effectiveness of FFR and IVUS PCI optimization strategies on the functional PCI result (assessed with FFR) immediately post-PCI and at 9–12 months after the treatment of long coronary lesions. Methods: This was a single-center study comparing post-PCI FFR between two different PCI optimization strategies (FFR and IVUS). The study included 154 patients who had hemodynamically significant long lesions, necessitating a stent length of 30 mm or more. The procedural outcomes were functional PCI result immediately post-PCI and at 9–12 months after treatment. Clinical outcomes included target vessel failure (TVF) and functional target vessel restenosis rate during follow-up. Results: Baseline clinical characteristics and FFR (0.65 [0.55–0.71]) did not differ significantly between the two groups and the left anterior descending artery was treated in 82% of cases. The FFR optimization strategy resulted in a significantly shorter stented segment (49 mm vs. 63 mm, p = 0.001) compared to the IVUS optimization strategy. Although the rates of optimal functional PCI result (FFR > 0.9) did not significantly differ between the FFR and IVUS optimization strategies, a proportion of patients in the FFR group (12%) experienced poor post-PCI functional outcome with FFR values ≤ 0.8, which was not observed in the IVUS group. At the 9–12 month follow-up, 20% of patients in the FFR group had target-vessel-related myocardial ischemia, compared to 6% in the IVUS group. The rates of TVF and functional target vessel restenosis during follow-up were also numerically higher in the FFR optimization group. Conclusions: The use of FFR PCI optimization strategy in the treatment of long coronary artery lesions is associated with a higher incidence of poor functional PCI result and larger myocardial ischemia burden at follow-up compared to the IVUS optimization strategy. However, this discrepancy did not translate into a statistically significant difference in clinical outcomes. This study highlights the importance of using IVUS to optimize long lesions functional PCI outcomes. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Coronary Artery Disease: Moving toward the Future)
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15 pages, 2303 KiB  
Article
Fractional Flow Reserve-Guided Stent Optimisation in Focal and Diffuse Coronary Artery Disease
by Hirofumi Ohashi, Damien Collison, Takuya Mizukami, Matthaios Didagelos, Koshiro Sakai, Muhammad Aetesam-ur-Rahman, Daniel Munhoz, Peter McCartney, Thomas J. Ford, Mitchell Lindsay, Aadil Shaukat, Paul Rocchiccioli, Richard Brogan, Stuart Watkins, Margaret McEntegart, Richard Good, Keith Robertson, Patrick O’Boyle, Andrew Davie, Adnan Khan, Stuart Hood, Hany Eteiba, Tetsuya Amano, Jeroen Sonck, Colin Berry, Bernard De Bruyne, Keith G. Oldroyd and Carlos Colletadd Show full author list remove Hide full author list
Diagnostics 2023, 13(15), 2612; https://doi.org/10.3390/diagnostics13152612 - 07 Aug 2023
Viewed by 1313
Abstract
Assessing coronary physiology after stent implantation facilitates the optimisation of percutaneous coronary intervention (PCI). Coronary artery disease (CAD) patterns can be characterised by the pullback pressure gradient (PPG) index. The impact of focal vs. diffuse disease on physiology-guided incremental optimisation strategy (PIOS) is [...] Read more.
Assessing coronary physiology after stent implantation facilitates the optimisation of percutaneous coronary intervention (PCI). Coronary artery disease (CAD) patterns can be characterised by the pullback pressure gradient (PPG) index. The impact of focal vs. diffuse disease on physiology-guided incremental optimisation strategy (PIOS) is unknown. This is a sub-study of the TARGET-FFR randomized clinical trial (NCT03259815). The study protocol directed that optimisation be attempted for patients in the PIOS arm when post-PCI FFR was <0.90. Overall, 114 patients (n = 61 PIOS and 53 controls) with both pre-PCI fractional flow reserve (FFR) pullbacks and post-PCI FFR were included. A PPG ≥ 0.74 defined focal CAD. The PPG correlated significantly with post-PCI FFR (r = 0.43; 95% CI 0.26 to 0.57; p-value < 0.001) and normalised delta FFR (r = 0.49; 95% CI 0.34 to 0.62; p-value < 0.001). PIOS was more frequently applied to vessels with diffuse CAD (6% focal vs. 42% diffuse; p-value = 0.006). In patients randomized to PIOS, those with focal disease achieved higher post-PCI FFR than patients with diffuse CAD (0.93 ± 0.05 vs. 0.83 ± 0.07, p < 0.001). There was a significant interaction between CAD patterns and the randomisation arm for post-PCI FFR (p-value for interaction = 0.004). Physiology-guided stent optimisation was applied more frequently to vessels with diffuse disease; however, patients with focal CAD at baseline achieved higher post-PCI FFR. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Coronary Artery Disease: Moving toward the Future)
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Review

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18 pages, 3279 KiB  
Review
Coronary Angiography Upgraded by Imaging Post-Processing: Present and Future Directions
by Benoit Caullery, Laurent Riou and Gilles Barone-Rochette
Diagnostics 2023, 13(11), 1978; https://doi.org/10.3390/diagnostics13111978 - 05 Jun 2023
Viewed by 1490
Abstract
Advances in computer technology and image processing now allow us to obtain from angiographic images a large variety of information on coronary physiology without the use of a guide-wire as a diagnostic information equivalent to FFR and iFR but also information allowing for [...] Read more.
Advances in computer technology and image processing now allow us to obtain from angiographic images a large variety of information on coronary physiology without the use of a guide-wire as a diagnostic information equivalent to FFR and iFR but also information allowing for the performance of a real virtual percutaneous coronary intervention (PCI) and finally the ability to obtain information to optimize the results of PCI. With specific software, it is now possible to have a real upgrading of invasive coronary angiography. In this review, we present the different advances in this field and discuss the future perspectives offered by this technology. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Coronary Artery Disease: Moving toward the Future)
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