Optical coherence tomography imaging of cardiac substrates

Area of Science:

• Biomedical Engineering
• Cardiovascular Imaging
• Cellular Biology

Background:

• Cardiovascular disease is a leading cause of death in the US.
• Understanding heart structure is vital for diagnosing and treating cardiac conditions.
• Cellular-scale imaging is needed for both clinical applications and basic research.

Purpose of the Study:

• To review the principles and applications of optical coherence tomography (OCT) for cardiac imaging.
• To highlight key considerations for imaging cardiac muscle with OCT.
• To discuss the potential of OCT in advancing cardiovascular research and patient care.

Main Methods:

• Review of optical coherence tomography (OCT) principles.
• Discussion of factors affecting cardiac OCT imaging: penetration, birefringence, and blood absorption.
• Highlighting various applications of cardiac OCT, including animal models, ablation monitoring, and human heart substrate characterization.

Main Results:

• OCT enables imaging of cardiac tissue structure at the myocyte scale (approx. 100 µm × 10 µm).
• Key imaging challenges include image penetration, tissue birefringence, and blood absorption.
• Cardiac OCT has demonstrated utility in small animal models, myofiber organization quantification, ablation lesion monitoring, and human heart substrate analysis.

Conclusions:

• Optical coherence tomography (OCT) is a powerful tool for detailed cardiac imaging.
• Advancements in OCT technology, including optical catheters and real-time processing, promise enhanced dynamic imaging and therapeutic guidance.
• OCT imaging of the heart holds significant promise for improving cardiovascular diagnostics, research, and treatment strategies.