Pub Date : 2023-11-30DOI: 10.20517/2574-1209.2023.124
Lamia Harik, Kevin R An, Arnaldo Dimagli, Roberto Perezgrovas-Olaria, G. Soletti, Jordan Leith, Michele Dell'Aquila, C. Rossi, Gianmarco Cancelli, Mario Gaudino
The choice of graft used to bypass stenoses in the coronary circulation is crucial to coronary artery bypass grafting (CABG) surgery and its success. Herein is a review of the existing literature on CABG grafts, including the discussion of utilization of different CABG grafts, patency of different grafts, and technical and other considerations pertinent to the use of each graft. Lastly, we present special considerations for graft selection in women.
{"title":"Choice of conduit for coronary artery bypass grafting: technical, anatomic, and pharmacologic considerations","authors":"Lamia Harik, Kevin R An, Arnaldo Dimagli, Roberto Perezgrovas-Olaria, G. Soletti, Jordan Leith, Michele Dell'Aquila, C. Rossi, Gianmarco Cancelli, Mario Gaudino","doi":"10.20517/2574-1209.2023.124","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.124","url":null,"abstract":"The choice of graft used to bypass stenoses in the coronary circulation is crucial to coronary artery bypass grafting (CABG) surgery and its success. Herein is a review of the existing literature on CABG grafts, including the discussion of utilization of different CABG grafts, patency of different grafts, and technical and other considerations pertinent to the use of each graft. Lastly, we present special considerations for graft selection in women.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"36 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139206108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-27DOI: 10.20517/2574-1209.2023.112
Abdullah H. Ghunaim, Dominique Vervoort, Lina A. Elfaki, Mimi X. Deng, Guillaume Marquis-Gravel, Stephen E. Fremes
Revascularization through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is used to manage left ventricular systolic dysfunction (LVSD) due to coronary artery disease (CAD). This review provides an overview of coronary revascularization for CAD with reduced left ventricular ejection fraction (LVEF), focusing on disparities in management. CABG provides more complete revascularization, and lower long-term all-cause mortality and reintervention and MI rates compared to PCI in patients with LVSD and CAD. Consequently, CABG is recommended as the primary revascularization therapy for CAD with reduced LVEF, with PCI being reserved for patients who are high-risk or have unfavorable coronary anatomy. Although LVSD increases revascularization risk, differential outcomes can be attributed to patients’ biological, behavioral, and socioeconomic factors as well as health system deficiencies. Women and racially and/or ethnically minoritized patients often present with progressive disease and greater comorbidity, experience delays in diagnosis and treatment, and have higher morbidity and mortality rates post-revascularization. These disparities may be explained by biological differences compounded by social determinants of health. Patients with CAD with LVSD pose unique medical challenges, which may be further complicated by disparities in care. Increased representation of minoritized patients in cardiovascular trials is needed to elucidate these differences and their long-term impact.
{"title":"Disparities in therapies for coronary artery disease with reduced left ventricular ejection fraction","authors":"Abdullah H. Ghunaim, Dominique Vervoort, Lina A. Elfaki, Mimi X. Deng, Guillaume Marquis-Gravel, Stephen E. Fremes","doi":"10.20517/2574-1209.2023.112","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.112","url":null,"abstract":"Revascularization through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is used to manage left ventricular systolic dysfunction (LVSD) due to coronary artery disease (CAD). This review provides an overview of coronary revascularization for CAD with reduced left ventricular ejection fraction (LVEF), focusing on disparities in management. CABG provides more complete revascularization, and lower long-term all-cause mortality and reintervention and MI rates compared to PCI in patients with LVSD and CAD. Consequently, CABG is recommended as the primary revascularization therapy for CAD with reduced LVEF, with PCI being reserved for patients who are high-risk or have unfavorable coronary anatomy. Although LVSD increases revascularization risk, differential outcomes can be attributed to patients’ biological, behavioral, and socioeconomic factors as well as health system deficiencies. Women and racially and/or ethnically minoritized patients often present with progressive disease and greater comorbidity, experience delays in diagnosis and treatment, and have higher morbidity and mortality rates post-revascularization. These disparities may be explained by biological differences compounded by social determinants of health. Patients with CAD with LVSD pose unique medical challenges, which may be further complicated by disparities in care. Increased representation of minoritized patients in cardiovascular trials is needed to elucidate these differences and their long-term impact.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139228623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-16DOI: 10.20517/2574-1209.2023.69
Sophie Maiocchi, Elizabeth N. Collins, Andrew Peterson, Kyle C Alexander, Dalton J. McGlamery, Noah A. Cassidy, John S. Ikonomidis, Adam W. Akerman
MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate translation and are involved in many pathological processes. They have emerged as promising biomarkers for diagnosis of conditions such as aortic aneurysm disease. Quantifying miRNAs in plasma is uniquely challenging because of the lack of standardized reproducible protocols. To facilitate the independent verification of conclusions, it is necessary to provide a thorough disclosure of all pertinent experimental details. In this technical note, we present a comprehensive protocol for quantifying plasma miRNAs using droplet digital PCR. We detail the entire workflow, including blood collection, plasma processing, cryo-storage, miRNA isolation, reverse transcription, droplet generation, PCR amplification, fluorescence reading, and data analysis. We offer comprehensive guidance regarding optimization, assay conditions, expected results, and insight into the troubleshooting of common issues. The stepwise normalization and detailed methodological guide enhance reproducibility. Moreover, multiple portions of this protocol may be automated. The data provided in this technical note is demonstrative of the values typically obtained when following its steps. To facilitate standardization in data reporting, we include a table of expected aortic aneurysm-related miRNA levels in healthy human plasma. This versatile protocol can be easily adapted to quantify most circulating miRNAs in plasma, making it a valuable resource for diagnostic development.
{"title":"Plasma microrna quantification protocol","authors":"Sophie Maiocchi, Elizabeth N. Collins, Andrew Peterson, Kyle C Alexander, Dalton J. McGlamery, Noah A. Cassidy, John S. Ikonomidis, Adam W. Akerman","doi":"10.20517/2574-1209.2023.69","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.69","url":null,"abstract":"MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate translation and are involved in many pathological processes. They have emerged as promising biomarkers for diagnosis of conditions such as aortic aneurysm disease. Quantifying miRNAs in plasma is uniquely challenging because of the lack of standardized reproducible protocols. To facilitate the independent verification of conclusions, it is necessary to provide a thorough disclosure of all pertinent experimental details. In this technical note, we present a comprehensive protocol for quantifying plasma miRNAs using droplet digital PCR. We detail the entire workflow, including blood collection, plasma processing, cryo-storage, miRNA isolation, reverse transcription, droplet generation, PCR amplification, fluorescence reading, and data analysis. We offer comprehensive guidance regarding optimization, assay conditions, expected results, and insight into the troubleshooting of common issues. The stepwise normalization and detailed methodological guide enhance reproducibility. Moreover, multiple portions of this protocol may be automated. The data provided in this technical note is demonstrative of the values typically obtained when following its steps. To facilitate standardization in data reporting, we include a table of expected aortic aneurysm-related miRNA levels in healthy human plasma. This versatile protocol can be easily adapted to quantify most circulating miRNAs in plasma, making it a valuable resource for diagnostic development.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139268373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.20517/2574-1209.2023.107
Gianni Dall’Ara, Giulia Alagna, Daniela Spartà, Miriam Compagnone, Simone Grotti, Giuseppe Guerrieri, Francesca Campanella, Giovanni Taverna, Marcello Galvani, Fabio Tarantino, Giuseppe Andò
Aim: To analyze the feasibility and procedural outcome of percutaneous coronary intervention (PCI) using rotational atherectomy (RA), performed via transradial sheathless guiding catheter, as compared to a standard radial and femoral vascular approach. Methods: All consecutive patients undergoing RA at two high-volume PCI centers from May 2011 to May 2023 were included. Comparisons were made between the two transradial approaches and between the three types of vascular access. Results: Two hundred twenty-three patients were enrolled. Baseline characteristics were similar, with the exception of gender. We observed, in percentages, fewer cases of failure for sheathless than standard transradial attempts (7.5% vs. 11.5%, respectively), whereas all trans-femoral attempts were successful. Transfemoral procedures were longer and more frequently performed under mechanical circulatory support. There was no difference in procedural success between the three vascular approaches. A trend towards a higher rate of vascular and bleeding complications was found in the femoral group. Conclusion: Sheathless transradial vascular access is a viable option when performing RA during complex PCI procedures, tending to result in fewer failures than the standard transradial approach and reduced bleeding and vascular complications compared to the femoral method.
{"title":"Sheathless radial approach in contemporary coronary rotational atherectomy: data from two high-volume centers","authors":"Gianni Dall’Ara, Giulia Alagna, Daniela Spartà, Miriam Compagnone, Simone Grotti, Giuseppe Guerrieri, Francesca Campanella, Giovanni Taverna, Marcello Galvani, Fabio Tarantino, Giuseppe Andò","doi":"10.20517/2574-1209.2023.107","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.107","url":null,"abstract":"Aim: To analyze the feasibility and procedural outcome of percutaneous coronary intervention (PCI) using rotational atherectomy (RA), performed via transradial sheathless guiding catheter, as compared to a standard radial and femoral vascular approach. Methods: All consecutive patients undergoing RA at two high-volume PCI centers from May 2011 to May 2023 were included. Comparisons were made between the two transradial approaches and between the three types of vascular access. Results: Two hundred twenty-three patients were enrolled. Baseline characteristics were similar, with the exception of gender. We observed, in percentages, fewer cases of failure for sheathless than standard transradial attempts (7.5% vs. 11.5%, respectively), whereas all trans-femoral attempts were successful. Transfemoral procedures were longer and more frequently performed under mechanical circulatory support. There was no difference in procedural success between the three vascular approaches. A trend towards a higher rate of vascular and bleeding complications was found in the femoral group. Conclusion: Sheathless transradial vascular access is a viable option when performing RA during complex PCI procedures, tending to result in fewer failures than the standard transradial approach and reduced bleeding and vascular complications compared to the femoral method.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136229248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.20517/2574-1209.2023.60
Vivian Carla Gomes, Mark A. Farber, F. Ezequiel Parodi
Spinal cord ischemia (SCI) is undoubtedly the most devastating adverse event that occurs after either a thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA) repair. While open surgery techniques and minimally invasive endovascular options are now available for treating complex anatomy aortic aneurysms, spinal cord ischemia still occurs to a greater extent than desirable. Multiple risk factors have been associated with this adverse event, such as advanced age, perioperative hypotension, extent of the repair, and ligation of multiple intercostal and lumbar arteries during the surgical repair. The present literature review aims to analyze the contributing risk factors for SCI in the context of aortic surgery, explore the most relevant strategies for preventing postoperative SCI, and discuss the current management strategy when this complication occurs.
{"title":"Strategies for prevention of spinal cord ischemia in the management of thoracic and thoracoabdominal aneurysms","authors":"Vivian Carla Gomes, Mark A. Farber, F. Ezequiel Parodi","doi":"10.20517/2574-1209.2023.60","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.60","url":null,"abstract":"Spinal cord ischemia (SCI) is undoubtedly the most devastating adverse event that occurs after either a thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA) repair. While open surgery techniques and minimally invasive endovascular options are now available for treating complex anatomy aortic aneurysms, spinal cord ischemia still occurs to a greater extent than desirable. Multiple risk factors have been associated with this adverse event, such as advanced age, perioperative hypotension, extent of the repair, and ligation of multiple intercostal and lumbar arteries during the surgical repair. The present literature review aims to analyze the contributing risk factors for SCI in the context of aortic surgery, explore the most relevant strategies for preventing postoperative SCI, and discuss the current management strategy when this complication occurs.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"398 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136102325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.20517/2574-1209.2023.113
Fabrizio Monaco, Jacopo D'Andria Ursoleo, Gaia Barucco, Margherita Licheri, Carolina Faustini, Stefano Lazzari, Ambra Licia Di Prima
Thoraco-abdominal aortic aneurysm (TAAA) open repair is a high-risk surgery further burdened with both mortality and morbidity. Despite numerous experimental endeavors and technical advancements, spinal cord ischemia (SCI) is still the most formidable morbidity to be resolved, irrespective of the open or endovascular surgical approach. It presents a spectrum of severity, ranging from temporary or permanent paraparesis to paraplegia with or without autonomic dysfunction. The timing of SCI occurrence is a crucial factor, with approximately 15% of cases manifesting intraoperatively, 50% within 48 h post-surgery, and the remaining 35% classified as late SCI, occurring more than 48 h after the procedure. The mechanism responsible for SCI is complex and multifactorial; hence, understanding its underlying pathophysiology is essential for its effective management. Over the last decade, strategies to enhance spinal cord perfusion and minimize the risk of SCI during TAAA open repair have been implemented. These include optimization of hemodynamics, hemoglobin levels, cardiac function, and cerebrospinal fluid pressure, ensuring collateral vascular network stability and distal aortic perfusion and intrathecal administration of drugs. A multimodal approach involving anesthesiologists and surgeons can lead to improved neurological recovery and a reduced incidence and severity of SCI.
{"title":"A multimodal approach to prevent spinal cord ischemia in patients undergoing thoracoabdominal aortic aneurism repair - from pathophysiology to anesthesiological management","authors":"Fabrizio Monaco, Jacopo D'Andria Ursoleo, Gaia Barucco, Margherita Licheri, Carolina Faustini, Stefano Lazzari, Ambra Licia Di Prima","doi":"10.20517/2574-1209.2023.113","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.113","url":null,"abstract":"Thoraco-abdominal aortic aneurysm (TAAA) open repair is a high-risk surgery further burdened with both mortality and morbidity. Despite numerous experimental endeavors and technical advancements, spinal cord ischemia (SCI) is still the most formidable morbidity to be resolved, irrespective of the open or endovascular surgical approach. It presents a spectrum of severity, ranging from temporary or permanent paraparesis to paraplegia with or without autonomic dysfunction. The timing of SCI occurrence is a crucial factor, with approximately 15% of cases manifesting intraoperatively, 50% within 48 h post-surgery, and the remaining 35% classified as late SCI, occurring more than 48 h after the procedure. The mechanism responsible for SCI is complex and multifactorial; hence, understanding its underlying pathophysiology is essential for its effective management. Over the last decade, strategies to enhance spinal cord perfusion and minimize the risk of SCI during TAAA open repair have been implemented. These include optimization of hemodynamics, hemoglobin levels, cardiac function, and cerebrospinal fluid pressure, ensuring collateral vascular network stability and distal aortic perfusion and intrathecal administration of drugs. A multimodal approach involving anesthesiologists and surgeons can lead to improved neurological recovery and a reduced incidence and severity of SCI.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"21 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136234057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-26DOI: 10.20517/2574-1209.2023.105
Andrea Núñez-Conde, Ignasi Rodríguez-Pintó, David A. Alba-Garibay, Alba Álvarez-Abella, Alba Jerez-Lienas, Oriol Llargués, M. Antonio Alba-Sánchez, Diana Oleas, Marco A. Alba
The clinical spectrum of cryoglobulinemic-associated diseases is broad and heterogeneous, with manifestations ranging from mild symptoms (e.g., isolated palpable purpura) to organ- and life-threatening involvement (e.g., membranoproliferative glomerulonephritis). Cryoglobulins are classified into three types. Type I cryoglobulinemia consists of one monoclonal immunoglobulin (Ig) and is practically always associated with B-cell lymphoproliferative disorders. In contrast, type II/III (mixed) cryoglobulinemia is composed of mono- or polyclonal IgM with rheumatoid factor activity bound to polyclonal IgG. Since the introduction of more efficient therapies for chronic hepatitis C virus (HCV), other diseases such as systemic autoimmune disorders and lymphoproliferative neoplasms have been established as the main causes of mixed cryoglobulinemic vasculitis. The pathogenesis of cryoglobulinemic vasculitis is a complex multifactorial process that involves B-cell aberrant lymphoproliferation and autoantibody production. Therefore, treatment of these patients may involve not only measures aimed to mitigate the severity of clinical manifestation but also those that address the associated underlying disease responsible for Ig production. The treatment of patients with type I cryoglobulinemia is primarily focused on controlling B lymphocyte clones responsible for cryoglobulin production, mostly with chemotherapy drugs. Treatment of mixed cryoglobulinemia syndrome is based on rituximab plus glucocorticoids, which induces remission in the vast majority of cases. In the rare patients that do not respond to rituximab administration, potential rescue approaches include alkylating agents, biologic therapies, conventional immunosuppression, and plasma exchange, although with partial efficacy. This narrative review explores the etiology, pathophysiology, clinical manifestations, treatment, and prognosis of nonviral cryoglobulinemic disease. A special focus is placed on the treatment of type I cryoglobulinemia and rituximab-resistant non-HCV cryoglobulinemic vasculitis.
{"title":"Nonviral cryoglobulinemic vasculitis: an updated review for clinical practice","authors":"Andrea Núñez-Conde, Ignasi Rodríguez-Pintó, David A. Alba-Garibay, Alba Álvarez-Abella, Alba Jerez-Lienas, Oriol Llargués, M. Antonio Alba-Sánchez, Diana Oleas, Marco A. Alba","doi":"10.20517/2574-1209.2023.105","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.105","url":null,"abstract":"The clinical spectrum of cryoglobulinemic-associated diseases is broad and heterogeneous, with manifestations ranging from mild symptoms (e.g., isolated palpable purpura) to organ- and life-threatening involvement (e.g., membranoproliferative glomerulonephritis). Cryoglobulins are classified into three types. Type I cryoglobulinemia consists of one monoclonal immunoglobulin (Ig) and is practically always associated with B-cell lymphoproliferative disorders. In contrast, type II/III (mixed) cryoglobulinemia is composed of mono- or polyclonal IgM with rheumatoid factor activity bound to polyclonal IgG. Since the introduction of more efficient therapies for chronic hepatitis C virus (HCV), other diseases such as systemic autoimmune disorders and lymphoproliferative neoplasms have been established as the main causes of mixed cryoglobulinemic vasculitis. The pathogenesis of cryoglobulinemic vasculitis is a complex multifactorial process that involves B-cell aberrant lymphoproliferation and autoantibody production. Therefore, treatment of these patients may involve not only measures aimed to mitigate the severity of clinical manifestation but also those that address the associated underlying disease responsible for Ig production. The treatment of patients with type I cryoglobulinemia is primarily focused on controlling B lymphocyte clones responsible for cryoglobulin production, mostly with chemotherapy drugs. Treatment of mixed cryoglobulinemia syndrome is based on rituximab plus glucocorticoids, which induces remission in the vast majority of cases. In the rare patients that do not respond to rituximab administration, potential rescue approaches include alkylating agents, biologic therapies, conventional immunosuppression, and plasma exchange, although with partial efficacy. This narrative review explores the etiology, pathophysiology, clinical manifestations, treatment, and prognosis of nonviral cryoglobulinemic disease. A special focus is placed on the treatment of type I cryoglobulinemia and rituximab-resistant non-HCV cryoglobulinemic vasculitis.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136381316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Continuous blood pressure (BP) monitoring can provide invaluable information for cardiovascular disease (CVD) diagnosis. The purpose of this study is to develop a deep recurrent neural network (RNN) model with an optimal feature set of photoplethysmogram (PPG) and electrocardiogram (ECG) signals for continuous BP estimation. Methods: This paper presents a novel deep recurrent neural network (RNN), which consists of 2-layered bidirectional Long Short-term Memory (Bi-LSTM) and 6-layered LSTM networks. It is used to estimate BP based on the optimal feature set of PPG and ECG signals. In this work, the optimal feature set is determined using five different feature selection methods. Results: The proposed method is evaluated based on 660 subjects from the University of California Irvine (UCI) machine learning repository. The RNN model with optimal feature set achieved root mean square error (RMSE) of 3.223 and 1.781 mmHg for systolic BP (SBP) and diastolic BP (DBP), respectively. It also showed mean absolute error (MAE) of 2.514 and 1.383 mmHg for SBP and DBP, respectively. Regarding the British Hypertension Society (BHS) standard, the results attained grade A for the estimation of SBP and DBP. Conclusion: The experimental results suggest that the proposed deep RNN model with an optimal feature set can improve the performance of BP prediction. Thus, it is possible to further apply our proposed method to develop a wearable device for real-time BP monitoring.
{"title":"Beat-to-beat continuous blood pressure estimation with optimal feature set of PPG and ECG signals using deep recurrent neural networks","authors":"Hanjie Chen, Liangyi Lyu, Zezhen Zeng, Yanwei Jin, Yuanting Zhang","doi":"10.20517/2574-1209.2023.30","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.30","url":null,"abstract":"Aim: Continuous blood pressure (BP) monitoring can provide invaluable information for cardiovascular disease (CVD) diagnosis. The purpose of this study is to develop a deep recurrent neural network (RNN) model with an optimal feature set of photoplethysmogram (PPG) and electrocardiogram (ECG) signals for continuous BP estimation. Methods: This paper presents a novel deep recurrent neural network (RNN), which consists of 2-layered bidirectional Long Short-term Memory (Bi-LSTM) and 6-layered LSTM networks. It is used to estimate BP based on the optimal feature set of PPG and ECG signals. In this work, the optimal feature set is determined using five different feature selection methods. Results: The proposed method is evaluated based on 660 subjects from the University of California Irvine (UCI) machine learning repository. The RNN model with optimal feature set achieved root mean square error (RMSE) of 3.223 and 1.781 mmHg for systolic BP (SBP) and diastolic BP (DBP), respectively. It also showed mean absolute error (MAE) of 2.514 and 1.383 mmHg for SBP and DBP, respectively. Regarding the British Hypertension Society (BHS) standard, the results attained grade A for the estimation of SBP and DBP. Conclusion: The experimental results suggest that the proposed deep RNN model with an optimal feature set can improve the performance of BP prediction. Thus, it is possible to further apply our proposed method to develop a wearable device for real-time BP monitoring.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135617150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-15DOI: 10.20517/2574-1209.2023.78
Riccardo Cau, Francesco Pisu, Giuseppe Muscogiuri, Lorenzo Mannelli, Jasjit S. Suri, Luca Saba
Carotid atherosclerotic disease is a widely acknowledged risk factor for ischemic stroke, making it a major concern on a global scale. To alleviate the socio-economic impact of carotid atherosclerotic disease, crucial objectives include prioritizing prevention efforts and early detection. So far, the degree of carotid stenosis has been regarded as the primary parameter for risk assessment and determining appropriate therapeutic interventions. Histopathological and imaging-based studies demonstrated important differences in the risk of cardiovascular events given a similar degree of luminal stenosis, identifying plaque structure and composition as key determinants of either plaque vulnerability or stability. The application of Artificial Intelligence (AI)-based techniques to carotid imaging can offer several solutions for tissue characterization and classification. This review aims to present a comprehensive overview of the main concepts related to AI. Additionally, we review the existing literature on AI-based models in ultrasound (US), computed tomography (CT), and Magnetic Resonance Imaging (MRI) for vulnerable plaque detection, and we finally examine the advantages and limitations of these AI approaches.
{"title":"Applications of artificial intelligence-based models in vulnerable carotid plaque","authors":"Riccardo Cau, Francesco Pisu, Giuseppe Muscogiuri, Lorenzo Mannelli, Jasjit S. Suri, Luca Saba","doi":"10.20517/2574-1209.2023.78","DOIUrl":"https://doi.org/10.20517/2574-1209.2023.78","url":null,"abstract":"Carotid atherosclerotic disease is a widely acknowledged risk factor for ischemic stroke, making it a major concern on a global scale. To alleviate the socio-economic impact of carotid atherosclerotic disease, crucial objectives include prioritizing prevention efforts and early detection. So far, the degree of carotid stenosis has been regarded as the primary parameter for risk assessment and determining appropriate therapeutic interventions. Histopathological and imaging-based studies demonstrated important differences in the risk of cardiovascular events given a similar degree of luminal stenosis, identifying plaque structure and composition as key determinants of either plaque vulnerability or stability. The application of Artificial Intelligence (AI)-based techniques to carotid imaging can offer several solutions for tissue characterization and classification. This review aims to present a comprehensive overview of the main concepts related to AI. Additionally, we review the existing literature on AI-based models in ultrasound (US), computed tomography (CT), and Magnetic Resonance Imaging (MRI) for vulnerable plaque detection, and we finally examine the advantages and limitations of these AI approaches.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"206 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135436733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-07DOI: 10.20517/2574-1209.2023.22
A. Sciahbasi, S. Minardi
Since the first balloon angioplasty 40 years ago, percutaneous coronary interventions (PCI) applicability continues to expand, even in the context of complex coronary anatomies, previously considered unsuitable for PCI. A very challenging scenario for PCI is the treatment of heavily calcified coronary stenosis that is associated with early complications and late adverse events. Countless tools and techniques have been introduced to treat calcified coronary stenosis, and among these, a new and promising technique obtained from lithotripsy technology employed for the treatment of uretero-renal calculi has been introduced: the intravascular lithotripsy (IVL). IVL utilizes acoustic shockwaves in a balloon-based delivery system that induces calcium fractures, facilitating stent advancement and expansion. This review aims to describe the device used for IVL, the results of clinical studies published, and the possible clinical use.
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