Skip to main content

Intracoronary Imaging and Intracoronary Functional Tests

  • Chapter
  • First Online:
  • 460 Accesses

Abstract

Coronary artery disease is the leading cause of morbidity and mortality worldwide and embodies the effect of atherosclerosis – a condition caused by the accumulation of cholesterol in the coronary arterial intima leading to chronic inflammation with endothelial dysfunction, luminal narrowing, and eventually plaque rupture and thrombosis. Understanding the pathophysiology of atherosclerosis and the processes taking place after coronary stent implantation is crucial for improving cardiovascular outcomes. This chapter presents the most commonly used diagnostic intracoronary imaging techniques and functional tests, with an emphasis on technical issues and specific findings related to the female gender.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Garcia-Garcia HM, Gogas BD, Serruys PW, Bruining N. IVUS-based imaging modalities for tissue characterization: similarities and differences. Int J Cardiovasc Imaging. 2011;27(2):215–24.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Radu MD, Kelbaek H, Jørgensen E, Helqvist S, Løjmand B, Engstrom T, Saunamaki K. Intracoronary optical coherence tomography: insights from clinical research – what do we need to learn? Curr Cardiovasc Imaging Rep. 2014;7:9286–302.

    Article  Google Scholar 

  3. Taniwaki M, Radu MD, Garcia-Garcia HM, Heg D, Kelbaek H, Holmvang L, Moschovitis A, Noble S, Pedrazzini G, Saunamaki K, Dijkstra J, Landmesser U, Wenaweser P, Meier B, Stefanini GG, Roffi M, Luscher TF, Windecker S, Raber L. Long-term safety and feasibility of three-vessel multimodality intravascular imaging in patients with ST-elevation myocardial infarction: the IBIS-4 (integrated biomarker and imaging study) substudy. Int J Cardiovasc Imaging. 2015;31(5):915–26.

    Article  PubMed  Google Scholar 

  4. Ruiz-Garcia J, Lerman A, Weisz G, Maehara A, Mintz GS, Fahy M, Xu K, Lansky AJ, Cristea E, Farah TG, Teles R, Botker HE, Templin B, Zhang Z, de Bruyne B, Serruys PW, Stone GW. Age- and gender-related changes in plaque composition in patients with acute coronary syndrome: the PROSPECT study. EuroIntervention. 2012;8(8):929–38.

    Article  PubMed  Google Scholar 

  5. Qian J, Maehara A, Mintz GS, Margolis MP, Lerman A, Rogers J, Banai S, Kazziha S, Castellanos C, Dani L, Fahy M, Stone GW, Leon MB. Impact of gender and age on in vivo virtual histology-intravascular ultrasound imaging plaque characterization (from the global Virtual Histology Intravascular Ultrasound [VH-IVUS] registry). Am J Cardiol. 2009;103(9):1210–4.

    Article  PubMed  Google Scholar 

  6. Lansky AJ, Ng VG, Maehara A, Weisz G, Lerman A, Mintz GS, De Bruyne B, Farhat N, Niess G, Jankovic I, Lazar D, Xu K, Fahy M, Serruys PW, Stone GW. Gender and the extent of coronary atherosclerosis, plaque composition, and clinical outcomes in acute coronary syndromes. JACC Cardiovasc Imaging. 2012;5(3 Suppl):S62–72.

    Article  PubMed  Google Scholar 

  7. Pundziute G, Schuijf JD, van Velzen JE, Jukema JW, van Werkhoven JM, Nucifora G, van der Kley F, Kroft LJ, de Roos A, Boersma E, Reiber JH, Schalij MJ, van der Wall EE, Bax JJ. Assessment with multi-slice computed tomography and gray-scale and virtual histology intravascular ultrasound of gender-specific differences in extent and composition of coronary atherosclerotic plaques in relation to age. Am J Cardiol. 2010;105(4):480–6.

    Article  PubMed  Google Scholar 

  8. Burke AP, Farb A, Malcom GT, Liang Y, Smialek JE, Virmani R. Plaque rupture and sudden death related to exertion in men with coronary artery disease. JAMA. 1999;281(10):921–6.

    Article  CAS  PubMed  Google Scholar 

  9. Cheruvu PK, Finn AV, Gardner C, Caplan J, Goldstein J, Stone GW, Virmani R, Muller JE. Frequency and distribution of thin-cap fibroatheroma and ruptured plaques in human coronary arteries: a pathologic study. J Am Coll Cardiol. 2007;50(10):940–9.

    Article  PubMed  Google Scholar 

  10. Guagliumi G, Capodanno D, Saia F, Musumeci G, Tarantini G, Garbo R, Tumminello G, Sirbu V, Coccato M, Fineschi M, Trani C, De Benedictis M, Limbruno U, De Luca L, Niccoli G, Bezerra H, Ladich E, Costa M, Biondi Zoccai G, Virmani R. Mechanisms of atherothrombosis and vascular response to primary percutaneous coronary intervention in women versus men with acute myocardial infarction: results of the OCTAVIA study. JACC Cardiovasc Interv. 2014;7(9):958–68.

    Article  PubMed  Google Scholar 

  11. Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, Mehran R, McPherson J, Farhat N, Marso SP, Parise H, Templin B, White R, Zhang Z, Serruys PW. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364(3):226–35.

    Article  CAS  PubMed  Google Scholar 

  12. Garcia-Garcia HM, Costa MA, Serruys PW. Imaging of coronary atherosclerosis: intravascular ultrasound. Eur Heart J. 2010;31(20):2456–69.

    Article  PubMed  Google Scholar 

  13. Nicholls SJ, Wolski K, Sipahi I, Schoenhagen P, Crowe T, Kapadia SR, Hazen SL, Tuzcu EM, Nissen SE. Rate of progression of coronary atherosclerotic plaque in women. J Am Coll Cardiol. 2007;49(14):1546–51.

    Article  PubMed  Google Scholar 

  14. Puri R, Nissen SE, Shao M, Ballantyne CM, Barter PJ, Chapman MJ, Erbel R, Libby P, Raichlen JS, Uno K, Kataoka Y, Nicholls SJ. Sex-related differences of coronary atherosclerosis regression following maximally intensive statin therapy: insights from SATURN. JACC Cardiovasc Imaging. 2014;7(10):1013–22.

    Article  PubMed  Google Scholar 

  15. Radu MD, Räber L, Gomez-Lara J, Kelbaek H, Stefanini GG, Jørgensen E, Helqvist S, Tellez A, Granada JF, Saunamaki K, Serruys PW, Windecker S. Optical coherence tomography for the assessment of intracoronary stents. In: Radu MD, Räber L, Garcia-Garcia HM, Serruys PW, editors. The clinical atlas of intravascular optical coherence tomography. Toulouse: Europa Edition; 2012.

    Google Scholar 

  16. Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Juni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann FJ, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A. 2014 ESC/EACTS Guidelines on myocardial revascularization: the task force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014;35(37):2541–619.

    Article  PubMed  Google Scholar 

  17. Zeglin-Sawczuk M, Jang IK, Kato K, Yonetsu T, Kim S, Choi SY, Kratlian C, Lee H, Dauerman HL. Lipid rich plaque, female gender and proximal coronary stent edge dissections. J Thromb Thrombolysis. 2013;36(4):507–13.

    Article  CAS  PubMed  Google Scholar 

  18. Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F, van’ t Veer M, Klauss V, Manoharan G, Engstrom T, Oldroyd KG, Ver Lee PN, MacCarthy PA, Fearon WF. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360(3):213–24.

    Article  CAS  PubMed  Google Scholar 

  19. Palmerini T, Biondi-Zoccai G, Della Riva D, Stettler C, Sangiorgi D, D’Ascenzo F, Kimura T, Briguori C, Sabate M, Kim HS, De Waha A, Kedhi E, Smits PC, Kaiser C, Sardella G, Marullo A, Kirtane AJ, Leon MB, Stone GW. Stent thrombosis with drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis. Lancet. 2012;379(9824):1393–402.

    Article  CAS  PubMed  Google Scholar 

  20. Kim HS, Tonino PA, De Bruyne B, Yong AS, Tremmel JA, Pijls NH, Fearon WF. The impact of sex differences on fractional flow reserve-guided percutaneous coronary intervention: a FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) substudy. JACC Cardiovasc Interv. 2012;5(10):1037–42.

    Article  PubMed  Google Scholar 

  21. Fineschi M, Guerrieri G, Orphal D, Palmerini E, Munzel T, Warnholtz A, Pierli C, Gori T. The impact of gender on fractional flow reserve measurements. EuroIntervention. 2013;9(3):360–6.

    Article  PubMed  Google Scholar 

  22. Nair PK, Marroquin OC, Mulukutla SR, Khandhar S, Gulati V, Schindler JT, Lee JS. Clinical utility of regadenoson for assessing fractional flow reserve. JACC Cardiovasc Interv. 2011;4(10):1085–92.

    Article  PubMed  Google Scholar 

  23. Sedlak T, Izadnegahdar M, Humphries KH, Bairey Merz CN. Sex-specific factors in microvascular angina. Can J Cardiol. 2014;30(7):747–55.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Li J, Rihal CS, Matsuo Y, Elrashidi MY, Flammer AJ, Lee MS, Cassar A, Lennon RJ, Herrmann J, Bell MR, Holmes DR, Bresnahan JF, Hua Q, Lerman LO, Lerman A. Sex-related differences in fractional flow reserve-guided treatment. Circ Cardiovasc Interv. 2013;6(6):662–70.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Pepine CJ, Anderson RD, Sharaf BL, Reis SE, Smith KM, Handberg EM, Johnson BD, Sopko G, Bairey Merz CN. Coronary microvascular reactivity to adenosine predicts adverse outcome in women evaluated for suspected ischemia results from the National Heart, Lung and Blood Institute WISE (Women’s Ischemia Syndrome Evaluation) study. J Am Coll Cardiol. 2010;55(25):2825–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Sen S, Escaned J, Malik IS, Mikhail GW, Foale RA, Mila R, Tarkin J, Petraco R, Broyd C, Jabbour R, Sethi A, Baker CS, Bellamy M, Al-Bustami M, Hackett D, Khan M, Lefroy D, Parker KH, Hughes AD, Francis DP, Di Mario C, Mayet J, Davies JE. Development and validation of a new adenosine-independent index of stenosis severity from coronary wave-intensity analysis: results of the ADVISE (ADenosine Vasodilator Independent Stenosis Evaluation) study. J Am Coll Cardiol. 2012;59(15):1392–402.

    Article  CAS  PubMed  Google Scholar 

  27. Escaned J, Echavarria-Pinto M, Garcia-Garcia HM, van de Hoef TP, de Vries T, Kaul P, Raveendran G, Altman JD, Kurz HI, Brechtken J, Tulli M, Von Birgelen C, Schneider JE, Khashaba AA, Jeremias A, Baucum J, Moreno R, Meuwissen M, Mishkel G, van Geuns RJ, Levite H, Lopez-Palop R, Mayhew M, Serruys PW, Samady H, Piek JJ, Lerman A. Prospective assessment of the diagnostic accuracy of instantaneous wave-free ratio to assess coronary stenosis relevance: results of ADVISE II International, Multicenter Study (ADenosine Vasodilator Independent Stenosis Evaluation II). JACC Cardiovasc Interv. 2015;8(6):824–33.

    Article  PubMed  Google Scholar 

  28. Cortigiani L, Rigo F, Gherardi S, Galderisi M, Bovenzi F, Picano E, Sicari R. Prognostic effect of coronary flow reserve in women versus men with chest pain syndrome and normal dipyridamole stress echocardiography. Am J Cardiol. 2010;106(12):1703–8.

    Article  PubMed  Google Scholar 

  29. Melikian N, Vercauteren S, Fearon WF, Cuisset T, MacCarthy PA, Davidavicius G, Aarnoudse W, Bartunek J, Vanderheyden M, Wyffels E, Wijns W, Heyndrickx GR, Pijls NH, de Bruyne B. Quantitative assessment of coronary microvascular function in patients with and without epicardial atherosclerosis. EuroIntervention. 2010;5(8):939–45.

    Article  PubMed  Google Scholar 

  30. Fearon WF, Low AF, Yong AS, McGeoch R, Berry C, Shah MG, Ho MY, Kim HS, Loh JP, Oldroyd KG. Prognostic value of the index of microcirculatory resistance measured after primary percutaneous coronary intervention. Circulation. 2013;127(24):2436–41.

    Article  PubMed  Google Scholar 

  31. Yong AS, Layland J, Fearon WF, Ho M, Shah MG, Daniels D, Whitbourn R, Macisaac A, Kritharides L, Wilson A, Ng MK. Calculation of the index of microcirculatory resistance without coronary wedge pressure measurement in the presence of epicardial stenosis. JACC Cardiovasc Interv. 2013;6(1):53–8.

    Article  PubMed  Google Scholar 

  32. Lee BK, Lim HS, Fearon WF, Yong AS, Yamada R, Tanaka S, Lee DP, Yeung AC, Tremmel JA. Invasive evaluation of patients with angina in the absence of obstructive coronary artery disease. Circulation. 2015;131(12):1054–60.

    Article  PubMed  Google Scholar 

  33. Räber L, Radu MD, Garcia-Garcia HM, Akasaka T, Banz Y, Kume T, Windecker S, Serruys PW. Atherosclerosis. In: Radu MD, Räber L, Garcia-Garcia HM, Serruys PW, editors. The clinical atlas of intravascular optical coherence tomography. Toulouse: Europa Edition; 2012.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maria D. Radu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Radu, M.D., Holmvang, L. (2017). Intracoronary Imaging and Intracoronary Functional Tests. In: Presbitero, P., Mehilli, J., Petronio, A. (eds) Percutaneous Treatment of Cardiovascular Diseases in Women. Springer, Cham. https://doi.org/10.1007/978-3-319-39611-8_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-39611-8_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-39609-5

  • Online ISBN: 978-3-319-39611-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics