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Journal of Geriatric Cardiology 2018年第2期15卷 199-202页

作者： Liang-Hong YING Yuan-Sheng FAN Yi LU Ke XU Chun-Jian LI Department of Cardiology the First Affiliated Hospital of Nanjing Medical University Nanjing China Department of Cardiology the Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital Huai'an China

Chronic total occlusion （CTO） occurs in approximately 20% known coronary atherosclerotic lesions, and CTO intervention has become a most challenging work. Although retrograde techniques have been applied and signifi... 详细信息

关键词： Chronic total occlusion intravascular ultrasound Percutaneous coronary intervention

Value of a new post-procedural intravascular ultrasound score in predicting target vessel revascularization after coronary drug-eluting stents implantation

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第8期13卷 624-630页

作者： Kai XU Ya-ling HAN Quan-min JING Shou-li WANG Ying-yan MA Xiao-zeng WANG Geng WANG Zu-lu WANG Department of Cardiology Shenyang Northern HospitalShenyang 110016China

Objective:There is no simple or feasible post-procedural intravascular ultrasound (IVUS) score to predict major adverse cardiac events (MACE) in patients undergoing drug-eluting stents (DES) implantation. The aim of this study is to validate a new IVUS score for predicting MACE. Methods:A total of 295 patients (with 322 lesions) were enrolled. IVUS score was calculated in each lesion based on five IVUS morphological characteristics:inflow/outflow disease, malapposition, underexpansion, tissue protrusion, and edge dissection (iMUTE score). We assigned two points to an underexpansion and one point for each presence of other factors. Patients were divided into low score (iMUTE score<2, n=137) and high score (iMUTE score≥2, n=158) groups. Results:At one year follow-up, a trend was seen in favor of the low iMUTE score group in MACE (3.65% vs. 10.10%; P=0.052), and there was more target vessel revascularization (TVR) in the high iMUTE score group compared with low score group (6.96% vs. 1.46%; P=0.044). Low iMUTE score was an independent predictor of freedom from TVR at one year (adjusted hazard ratio (HR) 0.5, 95% confidence interval (CI) 0.1-0.8; P=0.02). Conclusions:Post-procedural IVUS iMUTE scoring was simple and feasible in clinical practice, and can provide independent prognostic value for TVR in patients undergoing DES implantation.

关键词： intravascular ultrasound Drug eluting stents Scoring schemes percutaneous coronary intervention

The potential value of intravascular ultrasound imaging in diagnosis of aortic intramural hematoma

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Journal of Geriatric Cardiology 2011年第4期8卷 224-229页

作者： Wei Hu Francois Schiele Nicolas Meneveau Marie-France Seronde Pierre Legalery Jean-Francois Bonneville Sidney Chocron Jean-Pierre Bassand Department of Cardiology Min Hang District Central HospitalShanghai 201100China Department of Cardiology University Hospital Jean MinjozBesançon 25000France Department of Radiology University Hospital Jean MinjozBesançon 25000France Department of Cardiac Surgery University Hospital Jean MinjozBesançon 25000France

Objective To evaluate the potential value of intravascular ultrasound(IVUS)imaging in the diagnosis of aortic intramural hematoma(AIH).Methods From September 2002 to May 2005,a consecutive series of 15 patients with suspected aortic dissection(AD)underwent both IVUS imaging and spiral computed tomography(CT).Six patients diagnosed as acute type B AIH by CT or IVUS composed the present study *** The study group consisted of five males and one female with mean age of 66 years *** of them had chest or back *** one patient,CT omitted a localized AIH and an associated penetrating atherosclerotic ulcer(PAU),which were detected by *** another patient,CT mistaken a partly thrombosed false lumen as an AIH,whereas IVUS detected a subtle intimal tear and slow moving blood in the false *** the four rest patients,both CT and IVUS made the diagnosis of AIH,however,IVUS detected three PAUs in three of them,only one of them was also detected by CT,and two of them escaped initial CT and were confirmed by follow up CT or magnetic resonance *** IVUS imaging is a safe examination and has high accuracy in the diagnosis of AIH,particularly for diagnosing localized AIH,distinguishing AIH with thrombosed classic AD and detecting accompanied small PAUs.

关键词： intravascular ultrasound diagnosis aortic intramural hematom

Correlation between Characteristics of Coronary Plaque and Chinese Medicine Syndromes of Coronary Heart Disease:A Cross-Sectional Study Analysed by intravascular ultrasound

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Chinese Journal of Integrative Medicine 2022年第9期28卷 840-846页

作者： XU Dan-ping XU Jun-peng HE Zhi-ling PAN Guang-ming WANG Xia Department of Cardiology the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou510120Chin Postdoctoral Station of Fujian University of Chinese Medicine Fuzhou350122China The Second Clinical College of Guangzhou University of Chinese Medicine Guangzhou510120China

Objective:To analyse the correlation between the characteristics of coronary plaque in coronary heart disease(CHD)patients with phlegm-blood stasis syndrome(PBS)and blood stasis syndrome(BSS).Methods:Patients were divided into different groups based on Chinese medicine(CM)syndrome *** baseline demographics and clinical variables were collected from the medical ***,the characteristics of plaque and pathological manifestations in coronary artery were evaluated intravascular ultrasound(IVUS).Results:A total of 213 CHD patients were enrolled in two groups:184 were diagnosed with PBS and the remaining 29 were diagnosed with *** were no significant differences in age,body mases index,proportions of patients with high blood pressure,diabetes mellitus,smoking,hyperlipidemia,history of coronary artery bypass graft and percutaneous coronary intervention,medications,index from cardiac ultrasound image,blood lipids and C-reactive protein between the two groups(P>0.05),except gender,weight and proportions of OVUS observed target vessels(P<0.05 or P<0.01).More adverse events such as acute myocardial infarction(P=0.003)and unstable angina(P=0.048)were observed in ***,dissection,thrombus and coronary artery ectasia were significantly increased in BSS(P<0.05 or P<0.01).In contrast,PBS had more patients with stable angina and chronic total occlusion with significantly higher SYNTAX(synergy between percutaneous coronary intervention with Taxus and coronary artery bypass surgery)scores(P<0.05 or P<0.01).Moreover,dense-calcium was significantly elevated in PBS(P<0.01).Conclusions:Coronary plaque characteristics were correlated with different CM *** with PBS were associated with a higher degree of calcified plaque and severe coronary artery stenosis,indicating poor clinical prognosis but with a low probability of acute coronary *** contrast,the degree of calcified plaque in patients with BSS remained relatively low,

关键词： coronary heart disease coronary plaque intravascular ultrasound Chinese medicine syndrome syndrome differentiation

intravascular ultrasound-based analysis of factors affecting minimum lumen area in coronary artery intermediate lesions

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Journal of Geriatric Cardiology 2016年第2期13卷 169-174页

作者： Jian LIU Ying ZHANG Wei-Min WANG Zhao WANG Qi LI Chuan-Fen LIU Yu-Liang MA Ming-Yu LU Hong ZHAO Department of Cardiology Peking University People's Hospital Beijing China

Objective To identify clinical characteristics associated with the minimum lumen area （MLA） of proximal or middle intermediate lesions in the left anterior descending （LAD） artery, and to develop a model to predict MLA. Methods We retrospectively analyzed demographic data, medical history, and intravascular ultrasound findings for 90 patients with intermediate lesions in the LAD artery. Linear regression was used to identify factors affecting MLA, and multiple regression was used to develop a model for predicting MLA. Results Age, number of lesions, and diabetes mellitus correlated significantly with MLA of proximal or middle intermediate lesions. A regression model for predicting MLA （mm2） was derived from the data： 7.00 - 0.05 × （age） - 0.50 × （number of lesions）. A cut-off value of 3.1 mm2 was proposed for deciding when to perform percutaneous coronary intervention. Conclusion This model for predicting MLA of proximal or middle intermediate lesions in the LAD artery showed high accuracy, sensitivity, and specificity, indicating good diagnostic potential.

关键词： Intermediate lesions intravascular ultrasound Predictive model Risk factors

intravascular ultrasound Classification of Plaque in Angiographic True Bifurcation Lesions of the Left Main Coronary Artery

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Chinese Medical Journal 2016年第13期129卷 1538-1543页

作者： Li Li Debabrata Dash Lu-Yue Gai Yun-Shan Cao Qiang Zhao Ya-Rong Wang Yao-Jun Zhang Jun-Xia Zhang Department of Cardiology Guangzhou Red Cross Hospital Jinan University Guangzhou Guangdong 510020 China Department of Cardiology S. L. Raheja (A Fortis Associate) Hospital Mumbai Maharashtra India Oepartment of CardiologY'Chinese People's Liberation Army' General Hospital Beijing 100851 China Department of Cardiology Gansu Provincial People's Hospital Lanzhou Gansu 730000 China Department of Cardiology Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu 210006 China

Background： Accurately, characterizing plaques is critical for selecting the optimal intervention strategy for the left main coronary artery （LMCA） bifurcation. Coronary angiography cannot precisely assess the location or nature of plaques in bifurcation lesions. Few intravascular ultrasound （IVUS） classification scheme has been reported for angiographic imaging of true bifurcation lesions of the unprotected LMCA thus far. In addition, the plaque composition at the bifurcation has not been elucidated. This study aimed to detect plaque composition at LMCA bifurcation lesions by IVUS. Methods： Fifty-eight patients were recruited. The location, concentricity or eccentricity, site of maximum thickness, and composition of plaques of the distal LMCA, ostial left anterior descending （LAD） coronary artery and, left circumflex （LCX） coronary artery were assessed using IVUS and described using illustrative diagrams. Results： True bifurcation lesions of the unprotected LMCA were classified into four types： Type A, with continuous involvement from the distal LMCA to the ostial LAD and the ostial LCX with eccentric plaques; Type B, with concentric plaques at the distal LMCA, eccentric plaques at the ostial LAD, and no plaques at the LCX; Type C, with continuous involvement from the distal LMCA to the ostial LCX, with eccentric plaques, and to the ostial LAD, with eccentric plaques; and Type D, with continuous involvement from the distal LMCA to the ostial LAD, with eccentric plaques, and to the ostial LCX, with concentric plaques. The carina was involved in only 3.5% of the plaques. A total of 51.7% of the plaques at the ostium of the LAD were soft, while 44.8% and 44.6% were fibrous in the distal LMCA and in the ostial LCX, respectively. Conclusions： We classified LMCA true bifurcation lesions into four types. The carina was always free from disease. Plaques at the ostial LAD tended to be soft, whereas those at the ostial LCX and the distal LMCA tended to be fibrous.

关键词： intravascular ultrasound Left Main True Bifurcation Lesion Plaque

intravascular ultrasound assessment of very late bare-metal stent thrombosis： a case report

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Chinese Medical Journal 2012年第9期125卷 1658-1660页

作者： Ji Hyun Lee Kyung Min Kim Jun Won Lee Sung Gyun Ahn Young Jin Youn Division of Cardiology Wonju College of Medicine Yonsei University Korea

Very late stent thrombosis （VLST） is increasingly being regarded as a complication of drug-eluting stents （DES）, and delayed endothelization, local hypersensitivity reactions, and late stent malapposition due to excessive positive remodeling have been postulated as mechanisms. Considering that stent endothelialization seems to be completed within 4 weeks following bare-metal stent （BMS） placement and that BMS do not possess antiproliferative coating, the mechanism of VLST may differ between patients with DES and those with BMS. We report a case of VLST 9 years after BMS implantation, in which thrombus from the ruptured neointima was confirmed by intravascular ultrasound. This finding suggests that de novo plaque rupture at the neointimal layer within the stent may be one of the explanations for VLST.

关键词： very late stent thrombosis bare-metal stent intravascular ultrasound

Spontaneous multivessel coronary artery spasm diagnosed with intravascular ultrasound imaging:A case report

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World Journal of Clinical Cases 2020年第16期8卷 3601-3607页

作者： Hao-Yu Wu Yi-Wei Cao Feng-Jun Chang Lei Liang Department of Cardiology Shaanxi Provincial People's HospitalXi'an 710068Shaanxi ProvinceChina

BACKGROUND Coronary artery spasm is a major cause of myocardial *** coronary artery spasm has been known for a long time,its mechanism has not yet been *** clinicians,especially young clinicians pay less attention to coronary artery spasm,which may lead to some patients not being appropriately diagnosed and treated in *** report a patient with spontaneous multivessel coronary artery spasm for more than 30 years diagnosed with intravascular ultrasound(IVUS)*** SUMMARY A 66-year-old Chinese male patient had chest squeezing at rest for more than 30 *** had a history of cigarette smoking for more than 40 years and hypertension for 10 *** presenting at our institution,the patient had undergone coronary angiography 4 times and percutaneous transluminal coronary angioplasty procedures twice at other hospitals without a diagnosis of coronary artery ***,his chest symptoms *** multivessel coronary artery spasm occurred during IVUS without provocation testing,and the IVUS image was ***,the diagnosis of multifocal spontaneous coronary artery spasm was *** patient was placed on oral diltiazem,isosorbide mononitrate,and nicorandil to suppress coronary artery *** medications were given at the maximum dosages tolerated by the *** was discharged after 5 d without *** the six-month follow-up period,the patient was *** Coronary artery spasm is still prevalent in Eastern *** is essential for clinicians to be aware of coronary artery spasm,which may be hard to detect and can be lethal,in order to diagnose and treat patients appropriately.

关键词： Coronary artery spasm Multivessel coronary Spontaneous intravascular ultrasound Case report

Quantitative flow ratio and intravascular ultrasound guided percutaneous coronary intervention of left anterior descending lesion concomitant with severe coronary myocardial bridge

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Journal of Geriatric Cardiology 2019年第12期16卷 905-908页

作者： Xiao-Qing CAI Jing JING Jin WEN Wei-Jun YIN Yang LIU Wei HU Fei WANG Ling MA Shan-Shan ZHOU Tao ZHANG Feng TIAN Lian CHEN Yun-Dai CHEN Department of Cardiology the 940th Hospital of Joint Logistics Support Force of Chinese PLALanzhouChina Department of Cardiology the First Medical Center of Chinese PLA General HospitalBeijingChina Department of Medical Service the 940th Hospital of Joint Logistics Support Force of Chinese PLALanzhouChina Department of Cardiology the 305 Hospital of Chinese PLABeijingChina

Severe coronary stenosis concomitant with congenital coronary myocardial bridge(MB)is a tough scenario for cardiologist to perform revascularization,for which the complication rates including in-stent restenosis,stent fracture,stent thrombosis and even coronary perforation are still high.[1,2]Meanwhile,the necessity of revascularization in such patients is worth prudent *** imaging modalities are crucial and helpful in making revascularized decisions and ***,we report a case using quantitative flow ratio(QFR)and intravascular ultrasound(IVUS)to facilitate accurate revascularization in a patient with both severe coronary stenosis and deep coronary MB.

关键词： Coronary myocardial bridge intravascular ultrasound Percutaneous coronary intervention Quantitative flow ratio

Quantitative and qualitative assessment of non-obstructive left main coronary artery plaques using 64-multislice computed tomography compared with intravascular ultrasound

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Chinese Medical Journal 2010年第7期123卷 827-833页

作者： SHEN Yi QIAN Ju-ying WANG Ming-hui LIU Yuan LIU Xue-bo GE Lei MA Jian-ying GE Jun-bo Department of Internal Medicine Zhongshan Hospital Fudan University Shanghai Institute of Cardiovascular Diseases Shanghai 200032 China Department of Cardiology Zhongshan Hospital Fudan University Shanghai Institute of Cardiovascular Diseases Shanghai 200032 China Department of Cardiology Zhongshan Hospital Fudan University Shanghai Institute of Cardiovascular Diseases Shanghai 200032 China

Background There are few reports of quantitative and qualitative measuring of left main coronary artery （LMCA） plaques by multislice computed tomography coronary angiography （MSCTA）, especially when compared with intravascular ultrasound （IVUS） as reference standard. The aim of this study was to evaluate the use of 64-MSCTA in the diagnosis of LMCA disease, and the accuracy of MSCTA in the quantitative and qualitative assessment of the LMCA lesion as compared with *** A total of 91 patients （53 men, 38 women, mean age （64.78±9.19） years） were examined by 64-MSCTA and IVUS. Compared with the IVUS, the sensitivity, specificity, positive and negative predictive values （PPV and NPV） of the MSCTA on the diagnosis of LMCA diseases were calculated. Also, kappa index （K） for the agreement between MSCTA and IVUS was calculated. Minimal lumen area （MLA）, external elastic membrane cross-sectional area （EEM-CSA） and plaque burden were measured by two blinded and independent operators on MSCTA cross-sectional reconstruction and compared with the parameters measured from IVUS by manually tracing. The CT value of soft, fibrous and calcific plaques was measured using IVUS classification of the *** The sensitivity, specificity, PPV and NPV of MSCTA for detecting LMCA plaques were 93.1%, 84.2%, 95.7%, 76.2%, respectively. Kappa index （K=0.744, P〈0.001） indicated excellent agreement between MSCTA and IVUS. The Pearson index between MLA on IVUS and MLA on MSCTA was 0.815 （P 〈0.01）. The Pearson index of plaque burden and EEM-CSA between IVUS and MSCTA was 0.736 and 0.740 respectively （both P 〈0.01）. The CT value of soft plaque, fibrous plaque and calcific plaque compared with IVUS were （52.52±15.71） HU, （108.32±43.44） HU and （604.16±377.67） HU （P〈0.001）. Receiver operating characteristic curve analysis of CT value of non-calcific plaques for predicting soft plaques showed the cutpoint was 54.35 HU, with a sensitivity of 83.3% and specificity of 94.4%. Conclusions Si

关键词： multislice computed tomography intravascular ultrasound left main coronary artery