Coronary Artery Disease: Carlier S

Daemen J, Simoons ML, Wijns W, Bagust A, Bos G, Bowen JM, Braunwald E, Camenzind E, Chevaliers B, DiMario C, Fajadeto J, Gitt A, Guagliumi G, Hillege HL, James S, Jüni P, Kastrati A, Kloth S, Kristensen SD, Krucoff M, Legrand V, Pfisterer M, Rothman M, Serruys PW, Silber S, Steg PG, Tariah I, Wallentin L, Windecker SW, Aimonetti A, Allocco D, Berenger M, Boam A, Calle JP, Campo G, Carlier S, de Schepper J, Di Bisceglie G, Dobbels H, Farb A, Ghislain JC, Hellbardt S, ten Hoedt R, Isaia C, de Jong P, Lekehal M, LeNarz L, Mhullain FN, Nagai H, Patteet A, Paunovic D, Potgieter A, Purdy I, Raveau-Landon C, Ternstrom S, Van Wuytswinkel J, Waliszewski M, Anonymous00071. · Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. · EuroIntervention. · Pubmed #19284063 No free full text.

This publication has no abstract.

Dijkstra J, Carlier S. · No affiliation provided · Int J Cardiovasc Imaging. · Pubmed #14598899 No free full text.

This publication has no abstract.

García-García HM, Serruys PW, Mintz GS, Saito S, Klaus V, Margolis P, Carlier S, Goedhart D, Schwartz R. · Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. · JACC Cardiovasc Imaging. · Pubmed #19442952 No free full text.

Abstract: OBJECTIVES: This study explored whether an individual or a cluster of risk factors affects the extent of necrotic core (NC) assessed by intravascular ultrasound (IVUS) radiofrequency data (RFD) analysis. BACKGROUND: Several systemic diseases contribute to the development of coronary artery disease. METHODS: The Global Intravascular Radiofrequency Data Analysis Registry was a prospective, multicenter, nonrandomized database that enrolled 990 patients with coronary artery disease in whom 1 major coronary artery was imaged by IVUS-RFD. For the multivariable analysis, the population was divided into 4 classes: young women, young men (both <or=62 years), old women, and old men (>62 years). Mean NC area was categorized as 1: top quartile (>or=0.62 mm(2)) or as 0: lower 3 quartiles. RESULTS: Young patients had less NC compared with older patients (0.40 +/- 0.36 mm(2) of NC vs. 0.50 +/- 0.46 mm(2) in old patients, p = 0.0007). Nondiabetic patients had less NC than diabetic patients (0.43 +/- 0.41 mm(2) of NC vs. 0.51 +/- 0.44 mm(2) in diabetic patients, p = 0.02). The NC area was lower in normotensive patients (0.40 +/- 0.36 mm(2)) than in hypertensive patients (0.48 +/- 0.44 mm(2)) (p = 0.02). In the bivariate analysis, age, hypertension, diabetes, and prior coronary artery bypass graft were statistically significant, however in logistic regression analysis, only age (odds ratio [OR]: 1.023, 95% confidence interval [CI]: 1.009 to 1.037, p = 0.001) and diabetes (OR: 1.636, 95% CI: 1.174 to 2.279, p = 0.004) remained statistically significant. In a per-class logistic regression analyses including only diabetes as covariate, the OR in young women was 2.1 (95% CI: 0.77 to 6.0, p = 0.14), in young men the OR was 1.6 (95% CI: 0.90 to 2.7, p = 0.11), in old women the OR was 2.3 (95% CI: 1.09 to 4.9, p = 0.03), and in old men the OR was 1.6 (95% CI: 0.96 to 2.7, p = 0.07). Further, when only patients with diabetes and hypertension were included, young men (OR: 2.0, p = 0.041), old women (OR: 3.04, p = 0.046), and old men (OR: 2.2, p = 0.025) were significant. CONCLUSIONS: Individually and collectively, age and diabetes mellitus are associated with an increase in NC by IVUS-RFD analysis.

Vavuranakis M, Kakadiaris IA, O'Malley SM, Papaioannou TG, Sanidas EA, Naghavi M, Carlier S, Tousoulis D, Stefanadis C. · First Department of Cardiology, Hippokration Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece. · Int J Cardiol. · Pubmed #18068834 No free full text.

Abstract: BACKGROUND: Increased neovascularization in vasa vasorum and atherosclerotic plaques has recently been identified as a common feature of inflammation and plaque vulnerability. Microbubble contrast agents, which have been used for intravascular imaging, can be used to trace neovascularization. The aim of the study was to detect and evaluate the density of vasa vasorum in non-culprit coronary atherosclerotic plaques of patients with acute coronary syndrome. METHODS: We have studied intravascular ultrasound (IVUS) signals before, during, and after intracoronary injection of microbubbles, proximal to non-culprit atherosclerotic plaques in 16 patients with acute coronary syndrome. Analyses were accomplished using a computational algorithm for the detection of contrast perfusion in such contrast-enhanced sequences. Perfusion density was evaluated by the mean enhancement in the region of interest provided by this difference-imaging technique. RESULTS: Qualitative and quantitative analysis of the pre- and post-injection images showed a significant enhancement in the grey-scale intensity of intima-media and adventitia after injection (intima-media: from 6.0+/-2.5 to 7.9+/-3.3%, p=0.006 and adventitia: from 7.1+/-2.2 to 7.6+/-2.5%, p=0.035). CONCLUSIONS: Contrast-enhanced intravascular imaging is a novel, yet clinically available, technique that has the potential to enhance IVUS-based characterization of atherosclerotic plaques. The technique introduces a new perspective to the detection of vulnerable plaques and warrants further investigations.

Vavuranakis M, Kakadiaris IA, Papaioannou TG, O'Malley SM, Carlier S, Naghavi M, Stefanadis C. · Haimanda 24-26, Marousi 151 22, Athens, Greece. · Expert Rev Cardiovasc Ther. · Pubmed #17867921 No free full text.

Abstract: Acute coronary syndromes are the result of coronary plaque rupture in the majority of cases. Available diagnostic techniques that focus on the early detection of plaques that are prone to rupture are still limited. Increased neovascularization in the vasa vasorum of the atherosclerotic plaque has been identified recently as a common feature of inflammation and plaque vulnerability. Microbubbles, which have been used for ultrasound imaging, can be used to trace neovascularization. We present recent advances in contrast agents and contrast-enhanced intravascular ultrasound that may be used for the detection of vasa vasorum, including fundamental and harmonic contrast imaging. Identification of vasa vasorum proliferation in atherosclerotic plaques presents important clinical implications; in particular it could provide a means to detect vulnerability in vivo, thereby guiding targeted treatments.

Carlier S, Kakadiaris IA, Dib N, Vavuranakis M, O'Malley SM, Gul K, Hartley CJ, Metcalfe R, Mehran R, Stefanadis C, Falk E, Stone G, Leon M, Naghavi M. · Association for Eradication of Heart Attack-AEHA, 2472 Bolsover #439, Houston, TX 77005, USA. · Curr Atheroscler Rep. · Pubmed #15727733 No free full text.

Abstract: Complications of vulnerable atherosclerotic plaques (rupture, luminal and mural thrombosis, intraplaque hemorrhage, rapid progression to stenosis, spasm, and so forth) lead to heart attacks and strokes. It remains difficult to identify what plaques are vulnerable to these complications. Despite recent developments such as thermography, spectroscopy, and magnetic resonance imaging, none of them is approved for clinical use. Intravascular ultrasound (IVUS), a relatively old yet widely available clinical tool for guiding intracoronary procedures, is increasingly used for characterization of atherosclerotic plaques. However, inability of IVUS in measuring plaque activity limits its value in detection of vulnerable plaques. In this review, we present new information suggesting that microbubble contrast-enhanced IVUS can measure activity and inflammation within atherosclerotic plaques by imaging vasa vasorum density. An increasing body of evidence indicates that vasa vasorum density may be a strong marker for plaque vulnerability. We suggest that a combination of structural assessment (cap thickness, lipid core, calcification, etc) and vasa vasorum density imaging by IVUS can serve as the most powerful clinically available tool for characterization of vulnerable plaques. Due to space limitations, all IVUS images and movies are posted on the website of the Ultimate IVUS Collaborative Project: http://www.ultimateivus.com.

Lansky AJ, Mehran R, Dangas G, Cristea E, Shirai K, Costa R, Costantini C, Tsuchiya Y, Carlier S, Mintz G, Cottin Y, Stone G, Moses J, Leon MB. · Cardiovascular Research Foundation, Lenox Hill Heart and Vascular Institute, New York, New York 10022, USA. · Am J Cardiol. · Pubmed #15050498 No free full text.

Abstract: We evaluated the outcomes of 177 consecutive patients (43 women, 134 men) <40 years of age with premature atherosclerosis who underwent percutaneous coronary intervention. Women were younger, had more diabetes mellitus (37% vs 10%; p <0.001), but less hyperlipidemia (58% vs 75%; p <0.001) compared with men. In-hospital vascular complications and 1-year mortality rate or Q-wave myocardial infarction (7.9% vs 0.08%, p <0.01) were higher in women. By multivariable regression analysis, female gender was the only independent predictor of vascular complications (odds ratio, 14.1; 95% confidence intervals, 1.59 to 125, p = 0.01) and of 1-year mortality rate or nonfatal myocardial infarction (odds ratio, 12.5; 95% confidence interval, 1.14 to 111, p = 0.03). Women with premature coronary disease had a distinctive risk factor profile relative to men, with a predominance of diabetes and hypercholesterolemia, and were at higher risk of developing vascular and ischemic complications after percutaneous coronary intervention, warranting aggressive risk factor modification and vigilance in this population.

De Backer TL, De Buyzere M, Segers P, Carlier S, De Sutter J, Van de Wiele C, De Backer G. · Cardiovascular Center, Onze-Lieve-Vrouw Hospital, Moorselbaan 164, 9300, Aalst, Belgium. · Atherosclerosis. · Pubmed #12417289 No free full text.

Abstract: BACKGROUND: Impaired hemorheology has been demonstrated in atherosclerotic disease and has shown a relationship with classical risk factors. Blood viscosity (eta), being the ratio of shear stress over shear rate, is an important parameter of hemorheology. In women with premature coronary artery disease (CAD), the underlying risk factors are a matter of debate and the role of whole blood viscosity in its pathogenesis has not been documented. AIM: To investigate the association of whole blood viscosity with premature CAD in women, with complaints suggestive of angina pectoris. METHODS: Eighty-eight women (mean age 53 years) were divided into two groups, those with a high likelihood of CAD (LIKELI+) and those with a low likelihood of CAD (LIKELI-), based on medical history and technical investigations. Assessment of risk factors comprised smoking, diabetes mellitus, arterial hypertension, left ventricular hypertrophy (LVH), systolic and diastolic blood pressures, total low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, body mass index, menopause, hormone replacement therapy, uric acid and creatinine, and predicted 10-year cardiovascular risk according to the Framingham study was calculated. Whole blood viscosity was determined at 37 degrees C using a rotational cone-and-plate viscosimeter. RESULTS: Baseline characteristics did not differ significantly between the groups except for antiplatelet therapy (P=0.001), prevalence of diabetes mellitus (P=0.002), predicted 10-year cardiovascular risk (P=0.007), essential hypertension (P=0.02), LVH (P=0.03) and smoking habits (P=0.04). LIKELI+ women had a significantly higher whole blood viscosity at all shear rates compared with LIKELI- women (P<0.05). All blood viscosities measured from 25 to 125 s(-1) were highly significantly (P<0.0001) correlated with eta(250s(-1)). Univariate correlates with eta(250s(-1)) comprised triglycerides (P=0.006) and haematocrit (P=0.026). Binary logistic multivariate regression analysis for high likelihood of CAD revealed that only presence of arterial hypertension (P<0.0001) was predictive. Multiple regression analysis demonstrated that haematocrit (P=0.001) and likelihood of CAD (P=0.01) were the only significant determinants of eta(250s(-1)). CONCLUSION: In this study, blood viscosity did not appear as an independent risk factor for the prediction of premature CAD in women. Viscosity may act as a marker of CAD or of classical risk factors.

Segers P, Carlier S, Pasquet A, Rabben SI, Hellevik LR, Remme E, De Backer T, De Sutter J, Thomas JD, Verdonck P. · Hydraulics Laboratory, Institute of Biomedical Technology, University of Gent, 9000 Gent, Belgium. · Am J Physiol Heart Circ Physiol. · Pubmed #10924052 links to  free full text

Abstract: We fitted a three-segment transmission line model for the radial-carotid/aorta pressure transfer function (TFF) in 31 controls and 30 patients with coronary artery disease using noninvasively measured (tonometry) radial and carotid artery pressures (P(car)). Except for the distal reflection coefficient (0.85 +/- 0.21 in patients vs. 0.71 +/- 0.25 in controls; P < 0.05), model parameters were not different between patients or controls. Parameters were not related to blood pressure, age, or heart rate. We further assessed a point-to-point averaged TFF (TFF(avg)) as well as upper (TFF(max)) and lower (TFF(min)) enveloping TFF. Pulse pressure (PP) and augmentation index (AIx) were derived on original and reconstructed P(car) (P(car,r)). TFF(avg) yielded closest morphological agreement between P(car) and P(car,r) (root mean square = 4.3 +/- 2.3 mmHg), and TTF(avg) best predicted PP (41.5 +/- 11.8 vs. 41.1 +/- 10.0 mmHg measured) and AIx (-0.02 +/- 0.19 vs. 0.01 +/- 0.19). PP and AIx, calculated from P(car) or P(car,r), were higher in patients than in controls, irrespectively of the TFF used. We conclude that 1) averaged TFF yield significant discrepancies between reconstructed and measured pressure waveforms and subsequent derived AIx; and 2) different TFFs seem to preserve the information in the pressure wave that discriminates between controls and patients.

Krams R, Wentzel JJ, Cespedes I, Vinke R, Carlier S, van der Steen AF, Lancee CT, Slager CJ. · Laboratory Hemodynamics, Thoraxcenter, Erasmus University Rotterdam, The Netherlands. · Ultrasound Med Biol. · Pubmed #10414897 No free full text.

Abstract: Novel measurement techniques based on intravenous ultrasound (IVUS) technology ('IVUS-Flowmetry') require the location of a catheter inside the coronary bed. The present study quantifies disturbances in the 3-D velocity profile induced by catheter placement inside a tube, applying computational fluid dynamics. Two curved, circular meshes (radius K = 0.025 m and K = 0.035 m) with and without a catheter inside the lumen were applied. The catheter was located at the inner curve, the outer curve and at the top position. Boundary conditions were: no slip on the wall, zero stress at the outlet, uniform inflow with entrance velocities of 0.1, 0.2 and 0.4 m/s. Curvature-associated centrifugal forces shifted the maximal velocity to the outer curve and introduced two symmetrical vortices. Additional catheter placement redistributed the 3-D axial velocity field away from the catheter, which was accompanied by the appearance of multiple low-strength vortices. In addition, peak axial velocity increased, peak secondary velocities decreased, axial pressure drop increased and shear stress increased. Flow calculations simulated to resemble IVUS-based flowmetry changed by only 1% after considering secondary velocity. In conclusion, placement of a catheter inside a curved tube resembling the human coronary system changes the velocity field and reduces secondary patterns. The present study supports the usefulness of catheter-based flowmetry during resting flow conditions. During hyperemic flow conditions, flow measurements might be accompanied by large axial pressure drops because the catheter, itself, might act as a significant stenosis.

Mansour S, Vanderheyden M, De Bruyne B, Vandekerckhove B, Delrue L, Van Haute I, Heyndrickx G, Carlier S, Rodriguez-Granillo G, Wijns W, Bartunek J. · No affiliation provided · J Am Coll Cardiol. · Pubmed #16631016 No free full text.

This publication has no abstract.