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Early detection of cardiac allograft vasculopathy using highly automated 3-dimensional optical coherence tomography analysis

M. Pazdernik, Z. Chen, H. Bedanova, J. Kautzner, V. Melenovsky, V. Karmazin, I. Malek, A. Tomasek, E. Ozabalova, J. Krejci, J. Franekova, A. Wahle, H. Zhang, T. Kovarnik, M. Sonka,

. 2018 ; 37 (8) : 992-1000. [pub] 20180406

Jazyk angličtina Země Spojené státy americké

Typ dokumentu klinické zkoušky, časopisecké články, Research Support, N.I.H., Extramural, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc20006828

Grantová podpora
R01 EB004640 NIBIB NIH HHS - United States
NV16-27465A MZ0 CEP - Centrální evidence projektů

BACKGROUND: Optical coherence tomography (OCT)-based studies of cardiac allograft vasculopathy (CAV) published thus far have focused mainly on frame-based qualitative analysis of the vascular wall. Full capabilities of this inherently 3-dimensional (3D) imaging modality to quantify CAV have not been fully exploited. METHODS: Coronary OCT imaging was performed at 1 month and 12 months after heart transplant (HTx) during routine surveillance cardiac catheterization. Both baseline and follow-up OCT examinations were analyzed using proprietary, highly automated 3D graph-based optimal segmentation software. Automatically identified borders were efficiently adjudicated using our "just-enough-interaction" graph-based segmentation approach that allows to efficiently correct local and regional segmentation errors without slice-by-slice retracing of borders. RESULTS: A total of 50 patients with paired baseline and follow-up OCT studies were included. After registration of baseline and follow-up pullbacks, a total of 356 ± 89 frames were analyzed per patient. During the first post-transplant year, significant reduction in the mean luminal area (p = 0.028) and progression in mean intimal thickness (p = 0.001) were observed. Proximal parts of imaged coronary arteries were affected more than distal parts (p < 0.001). High levels of LDL cholesterol (p = 0.02) and total cholesterol (p = 0.031) in the first month after HTx were the main factors associated with early CAV development. CONCLUSIONS: Our novel, highly automated 3D OCT image analysis method for analyzing intimal and medial thickness in HTx recipients provides fast, accurate, and highly detailed quantitative data on early CAV changes, which are characterized by significant luminal reduction and intimal thickness progression as early as within the first 12 months after HTx.

Citace poskytuje Crossref.org

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$a BACKGROUND: Optical coherence tomography (OCT)-based studies of cardiac allograft vasculopathy (CAV) published thus far have focused mainly on frame-based qualitative analysis of the vascular wall. Full capabilities of this inherently 3-dimensional (3D) imaging modality to quantify CAV have not been fully exploited. METHODS: Coronary OCT imaging was performed at 1 month and 12 months after heart transplant (HTx) during routine surveillance cardiac catheterization. Both baseline and follow-up OCT examinations were analyzed using proprietary, highly automated 3D graph-based optimal segmentation software. Automatically identified borders were efficiently adjudicated using our "just-enough-interaction" graph-based segmentation approach that allows to efficiently correct local and regional segmentation errors without slice-by-slice retracing of borders. RESULTS: A total of 50 patients with paired baseline and follow-up OCT studies were included. After registration of baseline and follow-up pullbacks, a total of 356 ± 89 frames were analyzed per patient. During the first post-transplant year, significant reduction in the mean luminal area (p = 0.028) and progression in mean intimal thickness (p = 0.001) were observed. Proximal parts of imaged coronary arteries were affected more than distal parts (p < 0.001). High levels of LDL cholesterol (p = 0.02) and total cholesterol (p = 0.031) in the first month after HTx were the main factors associated with early CAV development. CONCLUSIONS: Our novel, highly automated 3D OCT image analysis method for analyzing intimal and medial thickness in HTx recipients provides fast, accurate, and highly detailed quantitative data on early CAV changes, which are characterized by significant luminal reduction and intimal thickness progression as early as within the first 12 months after HTx.
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$a Chen, Zhi $u Iowa Institute for Biomedical Imaging, University of Iowa, Iowa City, Iowa, USA.
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$a Bedanova, Helena $u Cardiovascular and Transplantation Surgery, Brno, Czech Republic.
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$a Kautzner, Josef $u Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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$a Melenovsky, Vojtech $u Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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$a Karmazin, Vladimir $u Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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$a Tomasek, Ales $u Cardiovascular and Transplantation Surgery, Brno, Czech Republic.
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$a Ozabalova, Eva $u Department of Cardiovascular Diseases, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic.
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$a Krejci, Jan $u Department of Cardiovascular Diseases, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic.
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$a Franekova, Janka $u Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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$a Wahle, Andreas $u Iowa Institute for Biomedical Imaging, University of Iowa, Iowa City, Iowa, USA.
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$a Zhang, Honghai $u Iowa Institute for Biomedical Imaging, University of Iowa, Iowa City, Iowa, USA.
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$a Kovarnik, Tomas $u Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Second Department of Internal Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
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