Eurointervention最新文献

{"title":"The invisible gorilla in the cath lab: can we fly away from it?","authors":"João Silva-Marques, Catarina Oliveira","doi":"10.4244/EIJ-D-24-00413","DOIUrl":"10.4244/EIJ-D-24-00413","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 20","pages":"e1264-e1266"},"PeriodicalIF":7.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Findings from transoesophageal echocardiographic follow-up after mitral transcatheter edge-to-edge repair.","authors":"Joanna Bartkowiak, Mohammad Kassar, Salomon J Brülisauer, Laura Bubulyte, Daryoush Samim, Andrea Ruberti, Raouf Madhkour, Lutz Büllesfeld, Stephan Windecker, Thomas Pilgrim, Nicolas Brugger, Fabien Praz","doi":"10.4244/EIJ-D-24-00297","DOIUrl":"10.4244/EIJ-D-24-00297","url":null,"abstract":"<p><strong>Background: </strong>Transoesophageal echocardiography (TOE) provides accurate evaluation of mitral valve (MV) function following mitral transcatheter edge-to-edge repair (M-TEER) and may better detect complications in case of suboptimal result.</p><p><strong>Aims: </strong>We aimed to evaluate midterm anatomical changes and structural complications after M-TEER using TOE and investigate their association with clinical outcomes at 2 years.</p><p><strong>Methods: </strong>A follow-up TOE at 6 months was systematically recommended to all patients included in our institutional prospective M-TEER registry until December 2021. We assessed changes in the incidence of mitral regurgitation (MR), MV stenosis (≥5 mmHg), and partial or complete single leaflet device attachment (SLDA) between the index procedure and follow-up and evaluated MV area and annular dimensions in a subset of patients with available three-dimensional (3D) datasets. The clinical endpoint was a composite of mortality and heart failure (HF) rehospitalisation at 2 years.</p><p><strong>Results: </strong>Among the 373 patients included in the registry between February 2012 and December 2021, 128 patients (34%) underwent elective TOE at 6 months. Using TOE, severe MR was observed in 13.3% (n=17) of the patients. The number of patients with an elevated MV gradient increased from 17 (13.3%) after the procedure to 23 (18%) at 6 months, and a new partial or complete SLDA was detected in 7.8% (n=10). Based on 3D TOE measurements, significant increases in MV area, annular area, annular perimeter, and intercommissural (but not anteroposterior) diameter were observed compared to intraprocedural images. A mean MV gradient ≥5 mmHg (hazard ratio [HR] 2.30, 95% confidence interval [CI]: 1.10-4.81; p=0.023) and the presence of severe MR at 6 months (HR 3.26, 95% CI: 1.18-8.99; p=0.023) were associated with the primary endpoint, which was met in 34 (26.6%) patients at 2 years.</p><p><strong>Conclusions: </strong>TOE follow-up allowed the detection of complications that would not be diagnosed using transthoracic echocardiography only and should therefore be used liberally in the patients presenting with a suboptimal result. A mean MV gradient ≥5 mmHg and severe MR, diagnosed at the 6-month TOE follow-up, were associated with adverse clinical outcomes.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 20","pages":"e1298-e1308"},"PeriodicalIF":7.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral valve edge-to-edge repair under scrutiny: what can we learn from transoesophageal echocardiographic follow-up?","authors":"Jörg Hausleiter, Lukas Stolz","doi":"10.4244/EIJ-E-24-00047","DOIUrl":"10.4244/EIJ-E-24-00047","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 20","pages":"e1262-e1263"},"PeriodicalIF":7.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative flow ratio will supplant wire-based physiological indices: pros and cons.","authors":"Niels Ramsing Holm, Birgitte Krogsgaard Andersen, Matthias Götberg","doi":"10.4244/EIJ-E-24-00031","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00031","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 19","pages":"e1199-e1201"},"PeriodicalIF":7.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absolute coronary blood flow across different endotypes of ANOCA.","authors":"Valeria Paradies, Pim Mathijs Smits, Matteo Maurina, Pietro L Laforgia, Marc M J M van der Linden, Peter Damman, Pieter C Smits","doi":"10.4244/EIJ-D-24-00111","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00111","url":null,"abstract":"<p><strong>Background: </strong>Intracoronary continuous thermodilution is a novel technique to quantify absolute true coronary flow and microvascular resistance. However, few data are available in patients with angina with non-obstructive coronary arteries (ANOCA).</p><p><strong>Aims: </strong>This study aimed to investigate the diagnostic potential of hyperaemic absolute coronary flow (Qmax) and absolute microvascular resistance (Rμ,hyper) among different ANOCA endotypes, and to determine the correlation between continuous - and bolus - thermodilution indexes.</p><p><strong>Methods: </strong>A total of 222 patients were scheduled for clinically indicated coronary function testing (CFT), of whom 120 patients were included in this analysis. These patients underwent CFT including acetylcholine (ACh) provocation testing and microvascular function assessment using both bolus and continuous thermodilution.</p><p><strong>Results: </strong>CFT was negative (CFT-) in 32 (26.7%) patients. Endothelium-dependent dysfunction (ACh+) was present in 63 (52.5%) patients, and coronary microvascular dysfunction (CMD) identified at bolus thermodilution (CMD+) was present in 62 (51.7%) patients. Patients with a positive CFT (CFT+) showed significantly lower Qmax and higher Rμ,hyper values as compared to CFT-. Qmax was significantly lower in CMD+ versus CMD- patients (0.174 vs 0.222 L/min; p=0.04) but did not differ in patients with or without a positive ACh test (0.198 vs 0.219 L/min; p=0.86).</p><p><strong>Conclusions: </strong>The prevalence of a CFT+ is high in a selected ANOCA population. In our study, Qmax and Rμ,hyper were associated with a positive CFT. Qmax was associated with the presence of microvascular dysfunction but not with a positive acetylcholine test. The novel continuous thermodilution method can provide further insights into ANOCA endotypes.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 19","pages":"e1227-e1236"},"PeriodicalIF":7.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absolute coronary flow and microvascular resistance before and after transcatheter aortic valve implantation.","authors":"Emanuele Gallinoro, Pasquale Paolisso, Dario Tino Bertolone, Giuseppe Esposito, Marta Belmonte, Attilio Leone, Michele Mattia Viscusi, Monika Shumkova, Cristina De Colle, Ivan Degrieck, Filip Casselman, Martin Penicka, Carlos Collet, Jeroen Sonck, Eric Wyffels, Jozef Bartunek, Bernard De Bruyne, Marc Vanderheyden, Emanuele Barbato","doi":"10.4244/EIJ-D-24-00075","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00075","url":null,"abstract":"<p><strong>Background: </strong>Severe aortic stenosis (AS) is associated with left ventricular (LV) remodelling, likely causing alterations in coronary blood flow and microvascular resistance.</p><p><strong>Aims: </strong>We aimed to evaluate changes in absolute coronary flow and microvascular resistance in patients with AS undergoing transcatheter aortic valve implantation (TAVI).</p><p><strong>Methods: </strong>Consecutive patients with AS undergoing TAVI with non-obstructive coronary artery disease in the left anterior descending artery (LAD) were included. Absolute coronary flow (Q) and microvascular resistance (R_μ) were measured in the LAD using continuous intracoronary thermodilution at rest and during hyperaemia before and after TAVI, and at 6-month follow-up. Total myocardial mass and LAD-specific mass were quantified by echocardiography and cardiac computed tomography. Regional myocardial perfusion (Q_N) was calculated by dividing absolute flow by the subtended myocardial mass.</p><p><strong>Results: </strong>In 51 patients, Q and R were measured at rest and during hyperaemia before and after TAVI; in 20 (39%) patients, measurements were also obtained 6 months after TAVI. No changes occurred in resting and hyperaemic flow and resistance before and after TAVI nor after 6 months. However, at 6-month follow-up, a notable reverse LV remodelling resulted in a significant increase in hyperaemic perfusion (Q_N,hyper: 0.86 [interquartile range {IQR} 0.691.06] vs 1.20 [IQR 0.99-1.32] mL/min/g; p=0.008; pre-TAVI and follow-up, respectively) but not in resting perfusion (Q_N,rest: 0.34 [IQR 0.30-0.48] vs 0.47 [IQR 0.36-0.67] mL/min/g; p=0.06).</p><p><strong>Conclusions: </strong>Immediately after TAVI, no changes occurred in absolute coronary flow or coronary flow reserve. Over time, the remodelling of the left ventricle is associated with increased hyperaemic perfusion.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 19","pages":"e1248-e1528"},"PeriodicalIF":7.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical coherence tomography to guide percutaneous coronary intervention.","authors":"Faisal Almajid, Do-Yoon Kang, Jung-Min Ahn, Seung-Jung Park, Duk-Woo Park","doi":"10.4244/EIJ-D-23-00912","DOIUrl":"https://doi.org/10.4244/EIJ-D-23-00912","url":null,"abstract":"<p><p>Percutaneous coronary intervention (PCI) has been most commonly guided by coronary angiography. However, to overcome the inherent limitations of conventional coronary angiography, there has been an increasing interest in the adjunctive tools of intracoronary imaging for PCI guidance. Recently, optical coherence tomography (OCT) has garnered substantial attention as a valid intravascular imaging modality for guiding PCI. However, despite the unparalleled high-resolution imaging capability of OCT, which offers detailed anatomical information on coronary lesion morphology and PCI optimisation, its broad application in routine PCI practice remains limited. Several factors may have curtailed the widespread adoption of OCT-guided PCI in daily practice, including the transitional challenge from intravascular ultrasound (IVUS), the experienced skill required for image acquisition and interpretation, the lack of a uniform algorithm for OCT-guided PCI optimisation, and the limited clinical evidence. Herein, we provide an in-depth review of OCT-guided PCI, involving the technical aspects, optimal strategies for OCT-guided PCI, and the wide application of OCT-guided PCI in various anatomical subsets. Special attention is given to the latest clinical evidence from recent randomised clinical trials with respect to OCT-guided PCI.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 19","pages":"e1202-e1216"},"PeriodicalIF":7.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid quantification of absolute perfusion requires accurate measurement of myocardial mass.","authors":"Nils P Johnson, K Lance Gould","doi":"10.4244/EIJ-E-24-00051","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00051","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 19","pages":"e1196-e1198"},"PeriodicalIF":7.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of fractional flow reserve using intravascular ultrasound.","authors":"Munenori Okubo, Masanori Kawasaki, Hiroyuki Yagami, Toru Tanigaki, Yoshiaki Kawase, Hitoshi Matsuo, Takahiko Suzuki","doi":"10.4244/EIJ-D-24-00010","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00010","url":null,"abstract":"<p><strong>Background: </strong>In order to identify coronary lesions that cause myocardial ischaemia and require revascularisation, fractional flow reserve (FFR) is widely recommended. Recently, a method of estimating the FFR using morphological features measured by an imaging device was developed. However, all the previously developed methods are conducted offline, and such analysis takes approximately 10 minutes.</p><p><strong>Aims: </strong>The aim of this present study was to develop an online measurement of the FFR using an intravascular ultrasound (IVUS) quantitative method (IQ-FFR).</p><p><strong>Methods: </strong>This prospective, single-centre study included coronary lesions that met the following criteria: (1) presence of at least one stenosis (25-99%); (2) both IVUS and FFR measurement performed just before and after stent implantation, with the wire-derived FFR measured with a standard method; and (3) acquisition of clear images throughout the entire coronary branch.</p><p><strong>Results: </strong>We developed an IVUS analysis system that automatically measures the cross-sectional area every 0.5 mm, and we calculated the IQ-FFR. In the prediction study, we calculated the IQ-FFR on the assumption that one stent of arbitrary length and diameter was implanted. After stent implantation, the wire-derived FFR was measured and compared with the calculated IQ-FFR. We compared 270 coronary lesions with stenosis rates of 32-99%. IQ-FFR measurements were strongly correlated with the wire-derived FFR (r=0.896). In the prediction study, the clinical accuracy of predicting whether the FFR would be greater or less than 0.80 after stent implantation was 87.5%.</p><p><strong>Conclusions: </strong>The IQ-FFR is a promising method to identify coronary lesions requiring revascularisation and to predict the FFR after stent implantation.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 19","pages":"e1237-e1247"},"PeriodicalIF":7.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplification of continuous intracoronary thermodilution.","authors":"Thabo Mahendiran, Samer Fawaz, Michele Viscusi, Danielle Keulards, Caïa Crooijmans, Tijn P J Jansen, Henk Everaars, Emanuele Gallinoro, Alessandro Candreva, Frederic Bouisset, Takuya Mizukami, Dario Bertolone, Marta Belmonte, Ruiko Seki, Johan Svanerud, Jeroen Sonck, Adriaan Wilgenhof, Thomas R Keeble, Peter Damman, Paul Knaapen, Carlos Collet, Nico H J Pijls, Bernard De Bruyne","doi":"10.4244/EIJ-D-24-00215","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00215","url":null,"abstract":"<p><strong>Background: </strong>Continuous intracoronary thermodilution with saline allows for the accurate measurement of volumetric blood flow (Q) and absolute microvascular resistance (R_μ). However, this requires repositioning of the temperature sensor by the operator to measure the entry temperature of the saline infusate, denoted as T_i.</p><p><strong>Aims: </strong>We evaluated whether Ti could be predicted based on known parameters without compromising the accuracy of calculated Q. This would significantly simplify the technique and render it completely operator independent.</p><p><strong>Methods: </strong>In a derivation cohort of 371 patients with Q measured both at rest and during hyperaemia, multivariate linear regression was used to derive an equation for the prediction of T_i. Agreement between standard Q (calculated with measured T_i) and simplified Q (calculated with predicted T_i) was assessed in a validation cohort of 120 patients that underwent repeat Q measurements. The accuracy of simplified Q was assessed in a second validation cohort of 23 patients with [¹⁵O]H₂O positron emission tomography (PET)-derived Q measurements.</p><p><strong>Results: </strong>Simplified Q exhibited strong agreement with standard Q (r=0.94, confidence interval [CI]: 0.93-0.95; intraclass correlation coefficient [ICC] 0.94, CI: 0.92-0.95; both p<0.001). Simplified Q exhibited excellent agreement with PET-derived Q (r=0.86, CI: 0.75-0.92; ICC=0.84, CI: 0.72-0.91; both p<0.001). Compared with standard Q, there were no statistically significant differences between correlation coefficients (p=0.29) or standard deviations of absolute differences with PET-derived Q (p=0.85).</p><p><strong>Conclusions: </strong>Predicting T_i resulted in an excellent agreement with measured T_i for the assessment of coronary blood flow. It significantly simplifies continuous intracoronary thermodilution and renders absolute coronary flow measurements completely operator independent.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 19","pages":"e1217-e1226"},"PeriodicalIF":7.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}