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Diagnostics
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Advanced Imaging in Acute Coronary Syndrome
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Advanced Imaging in Acute Coronary Syndrome

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 2683

Special Issue Editors

Dr. Luca Bergamaschi

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Guest Editor
1. Department of Medical and Surgical Sciences—DIMEC, University of Bologna, Bologna, Italy
2. IRCCS S. Orsola Hospital, 40138, Bologna, Italy
Interests: clinical cardiology; acute myocardial infarction; non-invasive imaging; cardiac imaging
Special Issues, Collections and Topics in MDPI journals
Dr. Carmine Pizzi

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Guest Editor
1. Department of Medical and Surgical Sciences—DIMEC, University of Bologna, Bologna, Italy
2. IRCCS S. Orsola Hospital, 40138 Bologna, Italy
Interests: clinical cardiology; acute myocardial infarction; chronic coronary syndrome; non-invasive imaging; preventive cardiology
Special Issues, Collections and Topics in MDPI journals
Dr. Marco Guglielmo

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Guest Editor
1. Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
2. Department of Cardiology, Haga Teaching Hospital, 2545 GM The Hague, The Netherlands
Interests: echocardiography; cardiac imaging; cardiac MRI; cardiac CT; cardiovascular imaging; transesophageal echocardiography; transthoracic echocardiography
Special Issues, Collections and Topics in MDPI journals
Dr. Anna Giulia Pavon

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Guest Editor
Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete, 48, 6900 Lugano, Switzerland
Interests: clinical cardiology; acute myocardial infarction; cardiomyopathies; mitral valve prolapse; non-invasive imaging; cardiac imaging; multimodality imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular disease (CVD) remains the leading global cause of mortality, particularly affecting low- and middle-income nations. The initial manifestation of CVD is often acute coronary syndrome (ACS). Echocardiography serves as the primary assessment for ACS patients. Recent trials have extensively explored Coronary CT angiography (CCTA) for evaluating those with suspected NSTE-ACS in emergency departments. Beyond depicting coronary anatomy, CCTA's capability to identify signs of coronary plaque instability holds promise for ACS assessment.

Furthermore, cardiac magnetic resonance (CMR) directly visualizes infarcted regions, providing insights into scarring and viability distinct from other myocardial injuries like myocarditis. CMR is pivotal in uncertain AMI diagnoses and vascular territory identification, and it aids in confirming myocarditis or takotsubo cardiomyopathy. In cases of myocardial infarction with non-obstructive coronary arteries (MINOCA), CMR's value is paramount.

Both intravascular coronary imaging techniques, Optical Coherence Tomography (OCT) and Intravascular Ultrasound (IVUS), are pivotal in sha** treatment strategies for ACS. Offering detailed insights into vascular and cardiac conditions, these imaging modalities are revolutionizing cardiovascular care.

The analysis of advanced non-invasive and invasive imaging in ACS holds tremendous potential, promising enhanced clinical management for these patients.

Dr. Luca Bergamaschi
Prof. Dr. Carmine Pizzi
Dr. Marco Guglielmo
Dr. Anna Giulia Pavon
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at mdpi.longhoe.net 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.

Keywords

  • acute coronary syndrome
  • non-invasive imaging
  • invasive imaging
  • cardiac magnetic resonance
  • coronary CT
  • echocardiography
  • OCT
  • IVUS
  • STEMI
  • NSTEMI
  • ischemic heart disease

Published Papers (3 papers)

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Research

12 pages, 1539 KiB  
Article
Comparison of Small Blood Vessel Diameter with Intravascular Ultrasound and Coronary Angiography for Guidance of Percutaneous Coronary Intervention
by Sergio A. Zuñiga-Mendoza, Emanuel Zayas-Diaz, Victoria R. Armenta-Velazquez, Ana A. Silva-Baeza, Juan J. Beltran-Ochoa, Misael A. Medina-Servin and Maria G. Zavala-Cerna
Diagnostics 2024, 14(12), 1312; https://doi.org/10.3390/diagnostics14121312 - 20 Jun 2024
Viewed by 471
Abstract
Major cardiovascular events (MACEs) are a cause of major mortality worldwide. The narrowing and blockage of coronary arteries with atherosclerotic plaques are diagnosed and treated with percutaneous coronary intervention (PCI). During this procedure, coronary angiography (CAG) remains the most widely used guidance modality [...] Read more.
Major cardiovascular events (MACEs) are a cause of major mortality worldwide. The narrowing and blockage of coronary arteries with atherosclerotic plaques are diagnosed and treated with percutaneous coronary intervention (PCI). During this procedure, coronary angiography (CAG) remains the most widely used guidance modality for the evaluation of the affected blood vessel. The measurement of the blood vessel diameter is an important factor to consider in order to decide if stent colocation is suitable for the intervention. In this regard, a small blood vessel (<2.75 mm) is majorly left without stent colocation; however, small vessel coronary artery disease (SvCAD) is a significant risk factor for the recurrence of MACEs, maybe due to the lack of a standardized treatment related to the diameter of the affected blood vessel; therefore, a more precise measurement is needed. The use of CAG for the measurement of the blood vessel diameter has some important limitations that can be improved with the use of newer techniques such as intravascular ultrasound (IVUS), although at higher costs, which might explain its underuse. To address differences in blood vessel diameter measurements and identify specific cases where IVUS might be of additional benefit for the patient, we conducted a retrospective study in patients who underwent PCI for MACEs with affection for at least one small blood vessel. We compared the measurements of the affected small blood vessels’ diameter obtained by CAG and IVUS to identify cases of reclassification of the affected blood vessel; additionally, we underwent a multivariate analysis to identify risk factors associated with blood vessel reclassification. We included information from 48 patients with a mean ± SD age of 69.1 ± 11.9 years; 70.8% were men and 29.2% were women. The mean diameter with CAG and IVUS was 2.1 mm (95% CI 1.9–2.2), and 2.8 (2.8–3.0), respectively. The estimated difference was of 0.8 mm (95% CI 0.7–0.9). We found a significant positive low correlation in diameter measurements of small blood vessels obtained with CAG and IVUS (r = 0.1242 p = 0.014). In total, 37 (77%) patients had a reclassification of the affected blood vessel with IVUS. In 21 cases, the affected blood vessel changed from a small to a medium size (2.75–3.00 mm), and in 15 cases, the affected vessel changed from a small to a large size (<3.00 mm). The Bland–Altman plot was used to evaluate agreement in measurements with CAG and IVUS. The change in blood vessel classification with IVUs was important for the decision of intervention and stent collocation. The only variable associated with reclassification of blood vessels after adjustment in a multivariate analysis was T2D (type 2 diabetes) (p = 0 0.035). Our findings corroborate that blood vessels might appear smaller with CAG, especially in patients with T2D; therefore, at least in these cases, the use of IVUS is recommended over CAG. Full article
(This article belongs to the Special Issue Advanced Imaging in Acute Coronary Syndrome)
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13 pages, 2641 KiB  
Article
Positive Echocardiographic Association between Carotid Artery and Coronary Artery Diameter and Z-Score in a Mouse Model of Kawasaki Disease
by Wen-Ling Shih, Tsung-Ming Yeh, Kuang-Den Chen, Steve Leu and Ho-Chang Kuo
Diagnostics 2024, 14(2), 145; https://doi.org/10.3390/diagnostics14020145 - 8 Jan 2024
Viewed by 891
Abstract
Kawasaki disease (KD) occurs in young children, has an unknown etiology, and can cause such life-threatening complications as coronary artery aneurysm. A mouse model using Lactobacillus casei cell wall extract (LCWE) with intraperitoneal injection was established for KD years ago. Histological examination of [...] Read more.
Kawasaki disease (KD) occurs in young children, has an unknown etiology, and can cause such life-threatening complications as coronary artery aneurysm. A mouse model using Lactobacillus casei cell wall extract (LCWE) with intraperitoneal injection was established for KD years ago. Histological examination of coronary artery lesions indicated features similar to those of vascular lesions of patients with KD. Since animals must be sacrificed during histological examination, the longitudinal survey of coronary artery lesions (CALs) is difficult. The aim of this study was to survey the vasculitis status of the coronary artery and the carotid artery in a KD mouse model. Method: LCWE was intraperitoneally injected into 5-week-old male C57BL/6 mice to induce CALs. We studied the longitudinal status of the carotid and coronary arteries and analyzed the Z-score of coronary artery diameter. Results: Carotid artery wall thickness (day 7) and diameter (day 14) significantly increased in the LCWE group with a dose-dependent effect (p < 0.05). Aortic diameter and wall thickness demonstrated significant increases on day 28 and day 7, respectively (p < 0.05). Carotid artery outer diameter and wall thickness were positively associated with coronary artery diameter on day 28 (p < 0.01). Coronary artery diameter significantly increased in the LCWE group after day 7 (p < 0.05). The percentage of Z > 3.0 indicated was more than 80% in the high-dose LCWE group and 0% in the control group. Conclusions: This report is the first to use coronary artery Z-score in a mouse model of KD by echocardiography and to find a positive association between carotid artery and coronary artery diameter. Full article
(This article belongs to the Special Issue Advanced Imaging in Acute Coronary Syndrome)
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14 pages, 1774 KiB  
Article
Coronary Tortuosity Index vs. Angle Measurement Method for the Quantification of the Tortuosity of Coronary Arteries in Non-Obstructive Coronary Disease
by Petra Zebic Mihic, Jerko Arambasic, Drazen Mlinarevic, Sandra Saric, Marina Labor, Ivica Bosnjak, Ivica Mihaljevic, Ines Bilic Curcic and Iva Juric
Diagnostics 2024, 14(1), 35; https://doi.org/10.3390/diagnostics14010035 - 23 Dec 2023
Viewed by 1032
Abstract
Coronary tortuosity has been recognized as a potential pathophysiological mechanism in the development of non-obstructive coronary artery disease (CAD). The aim of this study was to examine the role of two coronary tortuosity measurement methods in the detection of clinically significant coronary tortuosity. [...] Read more.
Coronary tortuosity has been recognized as a potential pathophysiological mechanism in the development of non-obstructive coronary artery disease (CAD). The aim of this study was to examine the role of two coronary tortuosity measurement methods in the detection of clinically significant coronary tortuosity. The study included 160 patients with angina symptoms and myocardial ischemia detected by cardiac stress tests in chronic settings and those diagnosed with acute coronary syndrome. After coronary angiography, tortuosity of coronary arteries was assessed by two methods, including measurement of tortuosity angles and calculating of tortuosity index. Significantly more tortuous coronary arteries were detected in the group with non-obstructive CAD (p < 0.01 for all three arteries), with significantly higher tortuosity index (TI) for all three coronary arteries in this group of patients, compared to patients with obstructive CAD. The highest TI for LCX was found in patients with lateral ischemia (p < 0.001) and for LAD in patients with anterior ischemia (p < 0.001). When measured by the angle method, the only association was found between LCX tortuosity and lateral ischemia (OR 4.9, p = 0.046). In conclusion, coronary tortuosity represents a pathophysiological mechanism for myocardial ischemia in non-obstructive CAD. The coronary tortuosity index could be a reliable and widely applicable tool for the quantification of coronary tortuosity. Full article
(This article belongs to the Special Issue Advanced Imaging in Acute Coronary Syndrome)
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