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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
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Prognostic Links Between OCT-Delineated Coronary Morphologies and Coronary Functional Abnormalities in Patients With

Kensuke Nishimiya1, Akira Suda1, Kento Fukui1

  • 1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

JACC. Cardiovascular Interventions
|March 19, 2021
PubMed

Insights

Coronary morphology in ischemia with nonobstructive coronary artery disease (INOCA) impacts prognosis. Optical coherence tomography findings like intraplaque neovessels (IPN) improve risk prediction in INOCA patients.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Imaging

Background:

  • Ischemia with nonobstructive coronary artery disease (INOCA) is common, yet the prognostic impact of coronary morphology remains unclear.
  • Understanding the relationship between coronary structure and function is crucial for managing INOCA patients.

Purpose of the Study:

  • To investigate the prognostic significance of coronary morphologies in patients with INOCA.
  • To determine if combining coronary morphology with functional assessments improves risk stratification.

Main Methods:

  • 329 INOCA patients underwent spasm provocation testing and lactate sampling.
  • Optical coherence tomography (OCT) evaluated adventitial vasa vasorum (AVV) and intraplaque neovessels (IPN).
  • Patients were classified based on epicardial and microvascular spasm (MVS) presence and type.

Main Results:

  • Microvascular spasm (MVS) frequently coexisted with diffuse and focal coronary spasm.
  • Focal coronary spasm was associated with the worst prognosis, significantly predicted by IPN.
  • Diffuse spasm showed greater AVV and an intermediate prognosis.

Conclusions:

  • Coronary morphology, assessed by OCT, provides significant prognostic information in INOCA patients.
  • Integrating OCT-derived parameters (AVV, IPN) with functional indices enhances prognostic accuracy for INOCA.
  • Both coronary morphology and functional abnormalities are important for risk assessment in INOCA.
Abstract

Keywords:
INOCAOCTcoronary microvascular dysfunctionspasmvasa vasorum

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