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Simultaneous Brightfield, Fluorescence, and Optical Coherence Tomographic Imaging of Contracting Cardiac Trabeculae Ex Vivo
Published on: October 2, 2021
Comprehensive appraisal of cardiac motion artefact in optical coherence tomography
Miao Chu1,2, Carlos Cortés3,4, Lili Liu5,1
1Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Insights
Cardiac motion artefact (CMA) in optical coherence tomography (OCT) is common. Shortening and elongation occur during specific cardiac phases, but diastasis offers accurate measurements free from CMA.
Area of Science:
- Cardiovascular Imaging
- Medical Device Technology
Background:
- Cardiac motion artefact (CMA) in optical coherence tomography (OCT) is a known issue.
- The precise relationship between CMA and the cardiac cycle phases remains unclear.
Purpose of the Study:
- To investigate the correlation between cardiac motion artefact (CMA) in OCT and specific cardiac cycle phases.
- To identify cardiac cycle phases optimal for accurate longitudinal measurements in stented vessels.
Main Methods:
- Retrospective analysis of OCT pullbacks co-registered with angiography in 261 stents.
- Qualitative assessment of CMA (rotation, shortening, elongation, repetition) during ejection, rapid-inflow, and diastasis phases.
- Quantitative sub-study measuring longitudinal connector length during different cardiac phases.
Main Results:
- CMA was detected in 23.4% of stents, with shortening during ejection and elongation/repetition during rapid-inflow.
- Rotation occurred in both ejection and rapid-inflow phases; diastasis showed no CMA.
- Vessel length changes were observed across phases, with diastasis providing a stable reference.
Conclusions:
- Cardiac motion artefact (CMA) is prevalent in OCT, with predictable patterns related to cardiac phases.
- Vascular structures exhibit length changes during ejection and rapid-inflow phases.
- Diastasis is the optimal cardiac phase for accurate longitudinal measurements in OCT, being free from CMA.
Background:
The relation between cardiac motion artefact (CMA) in optical coherence tomography (OCT) and the phases of cardiac cycle is unclear.
Methods:
Optical coherence tomography pullbacks containing metallic stents were co-registered with angiography and retrospectively analyzed. The beginning of three phases, namely ejection, rapid-inflow and diastasis, was identified in angiography. Rotation, shortening, elongation and repetition were qualitatively labelled as CMA artefacts. Platforms with coaxial longitudinal connectors (ML8 and Magmaris) entered a quantitative sub-study, consisting of measuring the length of their connector at the beginning of each phase.
Results:
A total of 261 stents (127 patients) were analyzed, including 105 stents for quantitative sub-study. CMA was detected in 61 (23.4%) stents: rotation in 6 (2.3%), shortening in 50 (19.2%), elongation in 51 (19.5%) and repetition in 12 (4.6%). Shortening was always observed during ejection phase, while elongation and repetition were always observed during rapid-inflow. Rotation occurred in both ejection and rapid-inflow phases, while no artefact was reported during diastasis. Longitudinal connectors measured in early ejection phase and in early rapid-inflow phase were shorter and longer, respectively, than those measured in diastasis, irrespective of the presence of CMA in the qualitative assessment.
Conclusions:
Cardiac motion artefact is prevalent in OCT studies, but shortening and elongation of vascular structures occur during early ejection and during early rapid-inflow, respectively, to a greater or lesser extent in all cases. Diastasis is free of CMA and hence the period in which longitudinal measurements can be more accurately quantified.
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