Cardiac Microanatomy Imaging Using Forward-Viewing Optical Coherence Tomography Endoscope.

Area of Science:

• Cardiovascular Imaging
• Biomedical Optics
• Cardiac Electrophysiology

Background:

• Current imaging technologies struggle to detect subtle cardiac microstructural changes linked to sudden cardiac death.
• Accurate visualization of subendocardial structures is crucial for understanding cardiac function and pathology.

Purpose of the Study:

• To develop a forward-viewing optical coherence tomography (OCT) endoscope for detailed cardiac microstructure detection.
• To visualize and characterize Purkinje fibers, scar tissue, myocytes, and adipose tissue in the subendocardium.

Main Methods:

• Developed a scanning fiber-based endoscopic OCT probe for contact measurements.
• Evaluated the probe in ovine hearts with myocardial infarction, correlating OCT findings with Masson's trichrome staining.
• Utilized volumetric imaging data to train a convolutional neural network (CNN) for 3D Purkinje fiber reconstruction.

Main Results:

• Successfully distinguished between healthy myocardium, fibrotic remodeling, and cardiac conduction system elements.
• Demonstrated the capability to capture detailed images of cardiac microstructures in large mammal hearts.
• Enabled visualization of cardiac microstructures within the subendocardium at depths accessible by optical methods.

Conclusions:

• A novel forward-viewing endoscopic OCT application in cardiology was established.
• This technology offers enhanced cellular-level visualization, potentially improving understanding of cardiac physiology and pathology.
• The method may inform future diagnostic and therapeutic strategies for cardiac conditions.