Comprehensive multimodality characterization of hemodynamically significant and non-significant coronary lesions using invasive and noninvasive measures
Engel LC, Landmesser U, Abdelwahed YS, Jaguszewski M, Gigengack K, Wurster TH, Skurk C, Manes C, Schuster A, Noutsias M, Hamm B, Botnar RM, Makowski MR, Bigalke B (2020)
Publication Type: Journal article
Publication year: 2020
Journal
Book Volume: 15
Article Number: e0228292
Journal Issue: 1
DOI: 10.1371/journal.pone.0228292
Abstract
Background There is limited knowledge about morphological molecular-imaging-derived parameters to further characterize hemodynamically relevant coronary lesions. Objective The aim of this study was to describe and differentiate specific parameters between hemodynamically significant and non-significant coronary lesions using various invasive and noninvasive measures. Methods This clinical study analyzed patients with symptoms suggestive of coronary artery disease (CAD) who underwent native T1-weighted CMR and gadofosveset-enhanced CMR as well as invasive coronary angiography. OCT of the culprit vessel to determine the plaque type was performed in a subset of patients. Functional relevance of all lesions was examined using quantitative flow reserve (QFR-angiography). Hemodynamically significant lesions were defined as lesions with a QFR <0.8. Signal intensity (contrast-to-noise ratios; CNRs) on native T1-weighted CMR and gadofosveset-enhanced CMR was defined as a measure for intraplaque hemorrhage and endothelial permeability, respectively. Results Overall 29 coronary segments from 14 patients were examined. Segments containing lesions with a QFR <0.8 (n = 9) were associated with significantly higher signal enhancement on Gadofosveset-enhanced CMR as compared to segments containing a lesions without significant stenosis (lesion-QFR>0.8; n = 19) (5.32 (4.47–7.02) vs. 2.42 (1.04–5.11); p = 0.042). No differences in signal enhancement were seen on native T1-weighted CMR (2.2 (0.68–6.75) vs. 2.09 (0.91–6.57), p = 0.412). 66.7% (4 out of 6) of all vulnerable plaque and 33.3% (2 out of 6) of all non-vulnerable plaque (fibroatheroma) as assessed by OCT were hemodynamically significant lesions. Conclusion The findings of this pilot study suggest that signal enhancement on albumin-binding probe-enhanced CMR but not on T1-weighted CMR is associated with hemodynamically relevant coronary lesions.
Involved external institutions
Charité - Universitätsmedizin Berlin
Germany (DE)
Georg-August-Universität Göttingen
Germany (DE)
Martin-Luther-Universität Halle-Wittenberg (MLU)
Germany (DE)
King’s College London
United Kingdom (GB)
Germany (DE)
Georg-August-Universität Göttingen
Germany (DE)
Martin-Luther-Universität Halle-Wittenberg (MLU)
Germany (DE)
King’s College London
United Kingdom (GB)
How to cite
APA:
Engel, L.-C., Landmesser, U., Abdelwahed, Y.S., Jaguszewski, M., Gigengack, K., Wurster, T.-H.,... Bigalke, B. (2020). Comprehensive multimodality characterization of hemodynamically significant and non-significant coronary lesions using invasive and noninvasive measures. PLoS ONE, 15(1). https://doi.org/10.1371/journal.pone.0228292
MLA:
Engel, Leif-Christopher, et al. "Comprehensive multimodality characterization of hemodynamically significant and non-significant coronary lesions using invasive and noninvasive measures." PLoS ONE 15.1 (2020).
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