JRSM Cardiovascular Disease最新文献

{"title":"Comparison of the use of blood pressure telemonitoring versus standard medical care in the achievement of short-term therapeutic goals in blood pressure in patients with uncontrolled hypertension: An open-label clinical trial.","authors":"M G Ramos-Zavala,&nbsp;F Grover-Páez,&nbsp;E G Cardona-Muñoz,&nbsp;D Cardona-Müller,&nbsp;A G Alanis-Sánchez,&nbsp;S Pascoe-González,&nbsp;D Roman-Rojas,&nbsp;C G Ramos-Becerra,&nbsp;H Alvarez-López,&nbsp;A Chávez-Mendoza,&nbsp;G J De la Peña-Topete,&nbsp;J M Enciso-Muñóz,&nbsp;A Estrada-Suárez,&nbsp;H Galvan-Oseguera,&nbsp;A Guerra-López,&nbsp;P Gutiérrez-Fajardo,&nbsp;K Lupercio-Mora,&nbsp;S N Nikos-Christo,&nbsp;S Palomo-Piñón,&nbsp;E Ruíz-Gastelum,&nbsp;R G Velasco-Sánchez","doi":"10.1177/20480040231178585","DOIUrl":"https://doi.org/10.1177/20480040231178585","url":null,"abstract":"<p><strong>Background: </strong>In Mexico less than half of the treated hypertensive patients reach blood pressure (BP) targets. Most hypertensive individuals rely on the standard medical care (SMC) to achieve the BP control goals; however, the efficacy of BP telemonitoring (BPT) to achieve BP targets has been poorly studied.</p><p><strong>Aim: </strong>To compare the efficacy of BPT versus SMC to achieve BP goals in patients with uncontrolled hypertension.</p><p><strong>Methods: </strong>A two-arm, open-label clinical trial was conducted in patients ≥18 years with uncontrolled hypertension. The participants were randomized to 2 arms (BPT vs SMC) and followed for 12 weeks. For the statistical analysis, the chi-squared test and covariance were used.</p><p><strong>Results: </strong>One hundred and seventy-eight participants were included, BPT (n = 94) and SMC (n = 84), after 12 weeks of follow up, we observed a baseline-adjusted reduction in systolic BP with both BPT (-13.5 [1.3] mmHg) and the SMC (-5.9 [1.4] mmHg; p < 0.001) but a greater decrease with BPT (p < 0.001). Likewise, we found a baseline-adjusted reduction of diastolic BP with BPT (-6.9 [0.9] mmHg) and SMC (-2.7 [0.9] mmHg) (p = 0.007) with a more significant percentage change from baseline with BPT (-6.8% [1.0] vs 2.5% [1.1]; p = 0.007). In the BPT arm, a larger proportion of patients achieved the BP target versus SMC (30.5% vs 12.8%; p = 0.005).</p><p><strong>Conclusion: </strong>BPT showed a greater proportion of patients achieving office BP control goals (<140/90 mmHg), compared to standard medical care.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"12 ","pages":"20480040231178585"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/4e/10.1177_20480040231178585.PMC10280509.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9710729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Velocity encoded mitral valve inflow cine: A novel and more reproducible method to determine cardiac rest periods during coronary magnetic resonance angiography","authors":"R. Markus, A. Tandon, Munes Fares, J. Dillenbeck, G. Greil, M. Batsis, Joshua S. Greer, A. Potersnak, Song Zhang, T. Hussain, S. Avula","doi":"10.1177/20480040221087556","DOIUrl":"https://doi.org/10.1177/20480040221087556","url":null,"abstract":"A high temporal resolution, 4-chamber (4CH) cine is the standard method for determining cardiac rest periods during whole heart coronary magnetic resonance angiography (CMRA). We evaluated the image quality and reproducibility between the 4CH cine method and a novel approach using a velocity encoded mitral valve inflow cine (MVI). The goal of this study was to compare the quality of CMRAs utilizing MVI versus 4CH methods. Sharpness and vessel length for the LCA and RCA using each method were determined using Soap Bubble and two blinded observers independently assessed coronary image quality. Offline analysis on a separate, retrospective cohort (n = 25) was used to compare MVI and 4CH reproducibility. In the prospectively evaluated cohort there was no difference in overall vessel sharpness (4CH vs MVI mean ± SD) (31.0 ± 5.5% vs 30.5 ± 5.7%, p = .63), LCA vessel sharpness (30.0 ± 5.4% vs 31.1 ± 8.2%, p = .44), LCA length (4.7 ± 1.4 cm vs 4.6 ± 1.6 cm, p = .66), RCA vessel sharpness (32.1 ± 6.9% vs 31.1 ± 7.7%, p = .55), RCA length (5.51 ± 2.6 cm vs 5.95 ± 2.4 cm, p = .38), or image quality rating (2.66 vs 2.62, p = .80) between methods. In the retrospective cohort, the MVI method had 5.4% lower inter-observer variability (95% CI 3.7,7.2%, p < .0001) and 3.9% lower intra-observer variability (95% CI 2.4,5.4%, p < .0001) than the 4CH method. MVI is a technically feasible and more reproducible method to determine cardiac rest periods compared to 4CH while preserving vessel sharpness, vessel length & image quality.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46656710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report","authors":"B. George, Michael R Sood","doi":"10.1177/20480040221082905","DOIUrl":"https://doi.org/10.1177/20480040221082905","url":null,"abstract":"Background With an incidence of less than 1%, a Coronary Artery to Pulmonary Artery fistula (CAPF) is a rare coronary anomaly that causes heart failure. It causes a left to right cardiac shunt. While guidelines favor surgical correction in symptomatic patients, we present a challenging case with multiple cardio-thoracic pathologies. Case Presentation We present a 38-year-old obese male with persistent atrial fibrillation (AF). He presented to our hospital in decompensated heart failure and AF with rapid ventricular response. He was found to have a CAPF, a bicuspid aortic valve and left lung hypoplasia in the presence of severely reduced left ventricular systolic dysfunction. The patient subsequently underwent various cardiac testing demonstrating advanced anatomical and physiologic involvement of his CAPF, including suggested coronary steal. Despite some indications for percutaneous or surgical referral, we optimized his AF and congestive heart failure in lieu of formulating a treatment strategy for his CAPF and other abnormalities. Conclusion This report illustrates a case of a young adult who presented in decompensated heart failure with newly diagnosed left ventricular systolic function and rapid AF, who had a triad of congenital defects including a CAPF, a bicuspid aortic valve and left lung hypoplasia. To the best of our knowledge, this triad of defects is unreported. This case highlights the clinical approach in the evaluation of a cardiac shunt and it's management strategies in the presence of multiple cardio-thoracic comorbidities.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"11 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42018703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring haemodynamic changes in rodent models to better inform safety pharmacology: Novel insights from <b><i>in vivo</i> studies and waveform analysis</b>.","authors":"Marieke Van Daele,&nbsp;Samantha L Cooper,&nbsp;Patrizia Pannucci,&nbsp;Edward S Wragg,&nbsp;Julie March,&nbsp;Iwan de Jong,&nbsp;Jeanette Woolard","doi":"10.1177/20480040221092893","DOIUrl":"https://doi.org/10.1177/20480040221092893","url":null,"abstract":"<p><p>Animal models are essential for assessing cardiovascular responses to novel therapeutics. Cardiovascular safety liabilities represent a leading cause of drug attrition and better preclinical measurements are essential to predict drug-related toxicities. Presently, radiotelemetric approaches recording blood pressure are routinely used in preclinical <i>in vivo</i> haemodynamic assessments, providing valuable information on therapy-associated cardiovascular effects. Nonetheless, this technique is chiefly limited to the monitoring of blood pressure and heart rate alone. Alongside these measurements, Doppler flowmetry can provide additional information on the vasculature by simultaneously measuring changes in blood flow in multiple different regional vascular beds. However, due to the time-consuming and expensive nature of this approach, it is not widely used in the industry. Currently, analysis of waveform data obtained from telemetry and Doppler flowmetry typically examines averages or peak values of waveforms. Subtle changes in the morphology and variability of physiological waveforms have previously been shown to be early markers of toxicity and pathology. Therefore, a detailed analysis of pressure and flowmetry waveforms could enhance the understanding of toxicological mechanisms and the ability to translate these preclinical observations to clinical outcomes. In this review, we give an overview of the different approaches to monitor the effects of drugs on cardiovascular parameters (particularly regional blood flow, heart rate and blood pressure) and suggest that further development of waveform analysis could enhance our understanding of safety pharmacology, providing valuable information without increasing the number of <i>in vivo</i> studies needed.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"11 ","pages":"20480040221092893"},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/b1/10.1177_20480040221092893.PMC9133998.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10600686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of the cardiac time intervals of the fetal ECG utilising a computerised algorithm: A retrospective observational study.","authors":"S C Chivers,&nbsp;T Vasavan,&nbsp;M Nandi,&nbsp;B R Hayes-Gill,&nbsp;I A Jayawardane,&nbsp;J M Simpson,&nbsp;C Williamson,&nbsp;W P Fifer,&nbsp;M Lucchini","doi":"10.1177/20480040221096209","DOIUrl":"https://doi.org/10.1177/20480040221096209","url":null,"abstract":"<p><strong>Objective: </strong>Establish whether the reliable measurement of cardiac time intervals of the fetal ECG can be automated and to address whether this approach could be used to investigate large datasets.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Teaching hospitals in London UK, Nottingham UK and New York USA.</p><p><strong>Participants: </strong>Singleton pregnancies with no known fetal abnormality.</p><p><strong>Methods: </strong>Archived fetal ECG's performed using the MonicaAN24 monitor. A single ECG (PQRST) complex was generated from 5000 signal-averaged beats and electrical cardiac time intervals measured in an automated way and manually.</p><p><strong>Main outcome measure: </strong>Validation of a newly developed algorithm to measure the cardiac time intervals of the fetal ECG.</p><p><strong>Results: </strong>188/236 (79.7%) subjects with fECGs of suitable signal:noise ratio were included for analysis comparing manual with automated measurement. PR interval was measured in 173/188 (92%), QRS complex in 170/188 (90%) and QT interval in 123/188 (65.4%). PR interval was 107.6 (12.07) ms [mean(SD)] manual vs 109.11 (14.7) ms algorithm. QRS duration was 54.72(6.35) ms manual vs 58.34(5.73) ms algorithm. QT-interval was 268.93 (21.59) ms manual vs 261.63 (36.16) ms algorithm. QTc was 407.5(32.71) ms manual vs 396.4 (54.78) ms algorithm. The QRS-duration increased with gestational age in both manual and algorithm measurements.</p><p><strong>Conclusion: </strong>Accurate measurement of fetal ECG cardiac time intervals can be automated with potential application to interpretation of larger datasets.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"11 ","pages":"20480040221096209"},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/3e/10.1177_20480040221096209.PMC9102181.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10253873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of malnutrition & frailty in patients with coronary artery disease: An under-recognized problem","authors":"Samiullah Arshad, Samina S. Khan, Adham Karim, Vedant A. Gupta","doi":"10.1177/20480040221102741","DOIUrl":"https://doi.org/10.1177/20480040221102741","url":null,"abstract":"Elderly patients with coronary artery disease have a high prevalence of frailty and malnutrition. Frailty syndrome is associated with poor outcomes in patients with myocardial infarction. There is a known overlap between frailty and malnutrition, yet these are two different entities. Fried Frailty Phenotype, Frail Scale, timed up and go test, and gait speed are rapid screening tests that may identify patients with frailty in everyday clinical setting. Short Form MNA is a sensitive tool to screen for malnutrition. Despite the availability of several tools for screening for both these conditions, the screening rates remain low. We aim to create awareness about the impacts of frailty and malnutrition, provide a brief overview of tools available and highlight the importance of screening in this high-risk population.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44363422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary tools and devices for coronary calcium modification","authors":"H. Bulluck, M. McEntegart","doi":"10.1177/20480040221089760","DOIUrl":"https://doi.org/10.1177/20480040221089760","url":null,"abstract":"With the aging population, up to a third of patients referred for percutaneous coronary intervention (PCI) have moderate or severe calcified lesions assessed by coronary angiography. The presence of coronary calcium is associated with difficult device delivery, sub-optimal stent deployment, and prolonged procedures, with more complications. Furthermore, it is known that sub-optimal stent expansion is associated with poor clinical outcomes. In this manuscript we describe how to quantify the severity of coronary calcium, review the armamentarium of contemporary devices available for calcium modification, and provide a systematic approach to device selection, assessment of successful calcium modification, and stent optimization.","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45043219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection.","authors":"Daisuke Arima,&nbsp;Yoshihiro Suematsu,&nbsp;Kanan Kurahashi,&nbsp;Satoshi Nishi,&nbsp;Akihiro Yoshimoto","doi":"10.1177/20480040211047122","DOIUrl":"https://doi.org/10.1177/20480040211047122","url":null,"abstract":"<p><strong>Purpose: </strong>Coagulation-fibrinolysis markers are widely used for the diagnosis of Stanford type A acute aortic dissection (SAAAD). However, the role of these markers in estimating prognosis remains unclear.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted to identify the relationship between preoperative D-dimer and fibrinogen levels on SAAAD postoperative early prognosis.</p><p><strong>Results: </strong>Of 238 SAAAD patients who underwent surgery between January 2012 and December 2018, 201 (84.5%) and 37 (15.5%) patients constituted the survival and non-survival groups, respectively, 30 days after surgery. D-dimer and fibrinogen levels in the survival and non-survival groups were 45.2 ± 74.3 vs. 91.5 ± 103.6 μg/mL (<i>p</i> = 0.014) and 224.3 ± 95.6 vs. 179.9 ± 96.7 μg/mL (<i>p</i> = 0.012), respectively. According to logistic predictor analysis of 30-day mortality, significant factors showed patent type (OR 10.89, 95% CI 1.66-20.31) and malperfusion (OR 4.63, 95% CI 1.74-12.32). Increasing D-dimer (per +10 μg/mL) and decreasing fibrinogen (per -10 μg/mL) were significantly associated with patent type and malperfusion. Receiver operating characteristic analysis was performed to distinguish between survival and non-survival. The cutoff value of D-dimer was 60 μg/mL (sensitivity 61.1%; specificity 82.5%; area under curve [AUC] 0.713 ± 0.083); fibrinogen was 150 mg/dL (sensitivity 44.4%; specificity 84.0%; AUC 0.647 ± 0.092). Kaplan-Meier survival curve analysis showed that patients with D-dimer levels > 60 μg/mL and fibrinogen levels < 150 mg/dL had significantly low survival rates at 30 days after surgery (60.0%, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Preoperative coagulation-fibrinolysis markers may be useful for predicting early prognosis in SAAAD.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"20480040211047122"},"PeriodicalIF":1.6,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/09/10.1177_20480040211047122.PMC8613881.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39763155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular health and risk of hospitalization with COVID-19: A Mendelian Randomization study.","authors":"Marina Cecelja,&nbsp;Cathryn M Lewis,&nbsp;Ajay M Shah,&nbsp;Phil Chowienczyk","doi":"10.1177/20480040211059374","DOIUrl":"https://doi.org/10.1177/20480040211059374","url":null,"abstract":"<p><strong>Background: </strong>Susceptibility to and severity of COVID-19 is associated with risk factors for and presence of cardiovascular disease.</p><p><strong>Methods: </strong>We performed a 2-sample Mendelian randomization to determine whether blood pressure (BP), body mass index (BMI), presence of type 2 diabetes (T2DM) and coronary artery disease (CAD) are causally related to presentation with severe COVID-19. Variant-exposure instrumental variable associations were determined from most recently published genome-wide association and meta-analysis studies (GWAS) with publicly available summary-level GWAS data. Variant-outcome associations were obtained from a recent GWAS meta-analysis of laboratory confirmed diagnosis of COVID-19 with severity determined according to need for hospitalization/death. We also examined reverse causality using exposure as diagnosis of severe COVID-19 causing cardiovascular disease.</p><p><strong>Results: </strong>We found no evidence for a causal association of cardiovascular risk factors/disease with severe COVID-19 (compared to population controls), nor evidence of reverse causality. Causal odds ratios (OR, by inverse variance weighted regression) for BP (OR for COVID-19 diagnosis 1.00 [95% confidence interval (CI): 0.99-1.01, P = 0.604] per genetically predicted increase in BP) and T2DM (OR for COVID-19 diagnosis to that of genetically predicted T2DM 1.02 [95% CI: 0.9-1.05, P = 0.927], in particular, were close to unity with relatively narrow confidence intervals.</p><p><strong>Conclusion: </strong>The association between cardiovascular risk factors/disease with that of hospitalization with COVID-19 reported in observational studies could be due to residual confounding by socioeconomic factors and /or those that influence the indication for hospital admission.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"20480040211059374"},"PeriodicalIF":1.6,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8619738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39927074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Vision Of Percutaneous Coronary Revascularisation In 2021: How to take advantage of intra-coronary imaging to perform more effective PCI.","authors":"Gavin Richards, Thomas Johnson","doi":"10.1177/20480040211049978","DOIUrl":"10.1177/20480040211049978","url":null,"abstract":"<p><p>The use of intracoronary imaging with intravascular ultrasound (IVUS) or optical coherence tomography (OCT) can define vessel architecture and has an established role in guidance and optimisation of percutaneous coronary intervention. Additionally intracoronary imaging has an emerging role in diagnosis, afforded by the ability to depict vessel wall characteristics not seen on angiography alone. Use of intracoronary imaging is recommended by international consensus guidelines from the European Society of Cardiology and two recent expert consensus position statements from the European Association of Percutaneous Coronary Interventions (EAPCI). However, uptake in contemporary practice in the United Kingdom appears to lag behind these recommendations. Imaging is particularly advantageous in complex coronary lesions (such as left main stem coronary artery, bifurcation, or heavily calcified lesions) and in complex patients (acute presentations, atypical presentations, and renal dysfunction). Stent detail to the level of individual struts can be appreciated with intracoronary imaging, which facilitates appropriate stent selection and optimisation of the final stent result. We highlight specific subgroups that benefit from an imaging guided approach to percutaneous coronary intervention. We review the evidence and the role of intracoronary imaging and highlight specific subgroups that show particular benefit from imaging guided percutaneous coronary intervention.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"10 ","pages":"20480040211049978"},"PeriodicalIF":1.4,"publicationDate":"2021-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/0b/10.1177_20480040211049978.PMC8851127.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39636369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}