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Updated: Aug 8, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Prediction of no reflow phenomenon in percutaneous coronary intervention with optical coherence tomography and
Shuangjun Gui1, Gaoshuang Fu2, Mengqi Jia1
1Department of Cardiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China. shuangjungui@163.com.
Insights
Optical coherence tomography (OCT) can predict the no-reflow phenomenon in myocardial infarction patients by measuring fibrous cap thickness. A cap thickness of 95 indicates the best prediction for no-reflow.
Area of Science:
- Cardiology
- Medical Imaging
- Interventional Therapy
Background:
- The no-reflow phenomenon is a critical complication in interventional therapy for acute ST-segment elevation myocardial infarction.
- Accurate prediction of no-reflow is essential for optimizing treatment strategies and improving patient outcomes.
Purpose of the Study:
- To evaluate the predictive value of plaque characteristics, specifically fibrous cap thickness, measured by optical coherence tomography (OCT) for the no-reflow phenomenon.
- To identify quantitative OCT parameters that can predict the occurrence of no-reflow during interventional procedures.
Main Methods:
- A cohort of 196 patients with acute ST-segment elevation myocardial infarction undergoing interventional therapy were analyzed.
- Patients were categorized into no-reflow (46 cases) and normal flow (150 cases) groups.
- Optical coherence tomography (OCT) was used to quantitatively measure fibrous cap thickness and lipid core angle of coronary plaques.
Main Results:
- Patients in the no-reflow group exhibited higher BMI, LDL, phospholipase A levels, family history of coronary heart disease, and thrombus load compared to the normal flow group (P<0.05).
- A significantly lower fibrous cap thickness was observed in the no-reflow group (P<0.05).
- Multivariate analysis identified fibrous cap thickness, phospholipase A, and severe thrombus load as independent risk factors for no-reflow (P<0.05).
- ROC curve analysis demonstrated that fibrous cap thickness has a high predictive value for no-reflow, with an optimal cutoff of 95 (AUC: 0.926, P<0.001).
Conclusions:
- Optical coherence tomography (OCT) provides a quantitative method to predict the no-reflow phenomenon in patients undergoing interventional therapy.
- Fibrous cap thickness, as measured by OCT, is a significant predictor of no-reflow, with a thickness of 95 offering the highest predictive accuracy.
Abstract:
Objective :To investigate the predictive value of no reflow phenomenon in interventional therapy by measuring plaque quantitatively with optical coherence tomography (OCT). Methods:196 patients with acute ST segment elevation myocardial infarction who visited the Department of Cardiology of the Second Affiliated Hospital of Zhengzhou University from January 2020 to January 2022 were selected as the study objects. According to whether there was no reflow during the operation, they were divided into no reflow group (46 cases) and normal flow group (150 cases). Systematically collect general clinical data and coronary angiography related data of patients through inpatient cases, measure fiber cap thickness and lipid core angle of diseased vascular plaque through optical coherence tomography, and analyze the relationship between fiber cap thickness and no reflow phenomenon Results:BMI, LDL, phospholipase A, the proportion of family history of coronary heart disease, and the thrombus load in the no reflow group were higher than those in the normal flow group (P<0.05), while the thickness of the fibrous cap was lower than that in the normal flow group (P<0.05); Further multivariate logistic regression analysis showed that fiber cap thickness, phospholipase A and severe thrombosis load were independent risk factors for non reflow phenomenon (P<0.05); Further ROC curve analysis found that the thickness of fiber cap had a high predictive value for no reflow phenomenon, and the best cutoff value for no reflow was 95, AUC: 0.926 (95% CI: 0.891-0.961, P<0.001). Conclusions: Optical coherence tomography can predict the occurrence of no reflow phenomenon by measuring the fiber cap thickness quantitatively. The prediction effect is the best when the fiber cap thickness is 95.
