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Impact of low tissue backscattering by optical coherence tomography on endothelial function after drug-eluting stent implantation

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Abstract

This study evaluated the impact of optical coherence tomography (OCT)-derived low-backscattered tissue on mid-term coronary endothelial function after drug-eluting stent (DES) implantation. Although OCT enables detailed in vivo evaluation of neointimal tissue characterization after DES implantation, its association with physiological vascular healing response is unclear. Thirty-three stable angina pectoris patients underwent OCT examination and endothelial function testing with intracoronary infusion of incremental doses of acetylcholine 8-month after DES implantation in a single lesion of the left anterior descending artery. Neointimal tissue was classified into two patterns based on the predominant OCT light backscatter: high backscatter and low backscatter. Although the presence of uncovered or malapposed stent strut was not associated with the degree of vasoconstriction, the degree of vasoconstriction was significantly greater in the DES with low-backscattered neointima than in the DES without low-backscattered neointima (− 32.1 ± 25.7 vs. − 4.1 ± 20.1%, p = 0.003). Moreover, there was an inverse linear relationship between low backscatter tissue index and degree of vasoconstriction after acetylcholine infusion (r = 0.50 and p = 0.003). The endothelium-dependent vasomotor response after 8-month of DES was impaired in patients with low neointimal tissue backscatter on OCT imaging. OCT assessment of low-backscattered tissue may be used as surrogate markers for impairment of endothelial function after DES.

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Acknowledgements

The authors thank the staff in the catheterization laboratory in Hyogo College of Medicine for their excellent assistance during the study.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan

    Hiroto Tamaru, Kenichi Fujii, Tsuyoshi Nakata, Masashi Fukunaga, Takahiro Imanaka, Kenji Kawai, Kojiro Miki, Tetsuo Horimatsu, Machiko Nishimura, Ten Saita, Akinori Sumiyoshi, Masahiko Shibuya, Yoshiro Naito, Tohru Masuyama & Masaharu Ishihara

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  1. Hiroto Tamaru
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Correspondence to Kenichi Fujii.

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Tamaru, H., Fujii, K., Nakata, T. et al. Impact of low tissue backscattering by optical coherence tomography on endothelial function after drug-eluting stent implantation. Cardiovasc Interv and Ther 34, 164–170 (2019). https://doi.org/10.1007/s12928-018-0540-y

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  • DOI: https://doi.org/10.1007/s12928-018-0540-y

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