Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography
Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography
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DOI：
10.1016/j.jcmg.2019.01.015
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发表时间：
2019-12-01
影响因子：
14
通讯作者：
Adlam, David
中科院分区：
文献类型：
--
作者：
Jackson, Robert;Al-Hussaini, Abtehale;Adlam, David
本研究应用光学相干断层扫描技术，通过观察开孔与非开孔冠状动脉夹层（SCAD）之间的差异、血管密度、冠状动脉造影剂浓度和冠状动脉造影剂浓度，探讨了自发性冠状动脉夹层（SCAD）假腔（FL）形成的机制。以及3）FL的光衰减特性。背景SCAD是日益被认识到的急性冠状动脉综合征的原因，其特征在于FL形成和真腔（TL）的压缩。FL形成的机制仍然知之甚少。方法共65例SCAD患者（68支血管）接受急性OCT成像作为常规临床护理的一部分。图像进行分类的TL和FL之间的连接（开窗）的存在或不存在。TL狭窄，外弹性膜（EEL）面积，FL面积，FL的光衰减的指数测量进行了评估。结果非开窗组EEL面积明显扩大（9.1%比-1.9%; P
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