Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography
Objectives. The aim of this study is to assess the utility of optical coherence tomography (OCT) in patients with exercise-related acute coronary syndrome (ACS) presenting with inconclusive angiographic findings. Background. Regular physical activity reduces the incidence of cardiovascular events. N...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/8263923 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850163953254006784 |
|---|---|
| author | Caterina Mas-Lladó Jaume Maristany Josep Gómez-Lara Marcos Pascual María del Mar Alameda Alfredo Gómez-Jaume Vicente Peral-Disdier |
| author_facet | Caterina Mas-Lladó Jaume Maristany Josep Gómez-Lara Marcos Pascual María del Mar Alameda Alfredo Gómez-Jaume Vicente Peral-Disdier |
| author_sort | Caterina Mas-Lladó |
| collection | DOAJ |
| description | Objectives. The aim of this study is to assess the utility of optical coherence tomography (OCT) in patients with exercise-related acute coronary syndrome (ACS) presenting with inconclusive angiographic findings. Background. Regular physical activity reduces the incidence of cardiovascular events. Nevertheless, the risk of ACS or sudden cardiac death (SCD) increases during sport. In adults older than 35 years, exercise-related ACS or SCD is associated with plaque rupture, but not infrequently patients present ambiguous angiographic findings. Methods. Between September 2015 and January 2020, patients admitted for ACS or SCD triggered by physical exertion and with coronary stenosis ≤50% were included in this prospective observational study. OCT was performed on the artery deemed to be responsible of the event. Results. Ten patients were enrolled, predominantly men (80%) of middle age (51 years old, IQR 41–63) with low cardiovascular risk burden. Cycling was the most frequent (50%) exercise-related trigger, 8 patients were regular sport practitioners, and 7 had the clinical event during strenuous exertion. Five patients presented with non-ST-elevation ACS, two with ST-elevation ACS, and three with SCD. Angiographic analysis showed nonsignificant stenosis in all patients (42% stenosis, IQR 36–46). OCT identified the etiology of the event in 9 patients (4 plaque erosion, 3 plaque rupture, 1 eruptive calcific nodule, and 1 coronary dissection). Treatment was adjusted according to OCT findings. Conclusions. OCT is a valuable technique to identify the etiology of exercise-related ACS or SCD in patients with nonobstructive coronary arteries and, as a result, may lead to a more specific treatment. |
| format | Article |
| id | doaj-art-efa94efee0694e42a8b9ffcbcf3ce606 |
| institution | OA Journals |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-efa94efee0694e42a8b9ffcbcf3ce6062025-08-20T02:22:05ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/82639238263923Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary AngiographyCaterina Mas-Lladó0Jaume Maristany1Josep Gómez-Lara2Marcos Pascual3María del Mar Alameda4Alfredo Gómez-Jaume5Vicente Peral-Disdier6Department of Cardiology, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, SpainDepartment of Cardiology, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, SpainDepartment of Cardiology, Hospital Universitari de Bellvitge, L’Hospitalet del Llobregat, Barcelona, SpainDepartment of Cardiology, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, SpainDepartment of Cardiology, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, SpainDepartment of Cardiology, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, SpainDepartment of Cardiology, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, SpainObjectives. The aim of this study is to assess the utility of optical coherence tomography (OCT) in patients with exercise-related acute coronary syndrome (ACS) presenting with inconclusive angiographic findings. Background. Regular physical activity reduces the incidence of cardiovascular events. Nevertheless, the risk of ACS or sudden cardiac death (SCD) increases during sport. In adults older than 35 years, exercise-related ACS or SCD is associated with plaque rupture, but not infrequently patients present ambiguous angiographic findings. Methods. Between September 2015 and January 2020, patients admitted for ACS or SCD triggered by physical exertion and with coronary stenosis ≤50% were included in this prospective observational study. OCT was performed on the artery deemed to be responsible of the event. Results. Ten patients were enrolled, predominantly men (80%) of middle age (51 years old, IQR 41–63) with low cardiovascular risk burden. Cycling was the most frequent (50%) exercise-related trigger, 8 patients were regular sport practitioners, and 7 had the clinical event during strenuous exertion. Five patients presented with non-ST-elevation ACS, two with ST-elevation ACS, and three with SCD. Angiographic analysis showed nonsignificant stenosis in all patients (42% stenosis, IQR 36–46). OCT identified the etiology of the event in 9 patients (4 plaque erosion, 3 plaque rupture, 1 eruptive calcific nodule, and 1 coronary dissection). Treatment was adjusted according to OCT findings. Conclusions. OCT is a valuable technique to identify the etiology of exercise-related ACS or SCD in patients with nonobstructive coronary arteries and, as a result, may lead to a more specific treatment.http://dx.doi.org/10.1155/2020/8263923 |
| spellingShingle | Caterina Mas-Lladó Jaume Maristany Josep Gómez-Lara Marcos Pascual María del Mar Alameda Alfredo Gómez-Jaume Vicente Peral-Disdier Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography Journal of Interventional Cardiology |
| title | Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography |
| title_full | Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography |
| title_fullStr | Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography |
| title_full_unstemmed | Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography |
| title_short | Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography |
| title_sort | optical coherence tomography for the diagnosis of exercise related acute cardiovascular events and inconclusive coronary angiography |
| url | http://dx.doi.org/10.1155/2020/8263923 |
| work_keys_str_mv | AT caterinamasllado opticalcoherencetomographyforthediagnosisofexerciserelatedacutecardiovasculareventsandinconclusivecoronaryangiography AT jaumemaristany opticalcoherencetomographyforthediagnosisofexerciserelatedacutecardiovasculareventsandinconclusivecoronaryangiography AT josepgomezlara opticalcoherencetomographyforthediagnosisofexerciserelatedacutecardiovasculareventsandinconclusivecoronaryangiography AT marcospascual opticalcoherencetomographyforthediagnosisofexerciserelatedacutecardiovasculareventsandinconclusivecoronaryangiography AT mariadelmaralameda opticalcoherencetomographyforthediagnosisofexerciserelatedacutecardiovasculareventsandinconclusivecoronaryangiography AT alfredogomezjaume opticalcoherencetomographyforthediagnosisofexerciserelatedacutecardiovasculareventsandinconclusivecoronaryangiography AT vicenteperaldisdier opticalcoherencetomographyforthediagnosisofexerciserelatedacutecardiovasculareventsandinconclusivecoronaryangiography |