Authors

• Kristijana Radić — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-6098-254X
• Matija Vrbanić — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-3229-9436
• Ivica Benko — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-1878-0880
• Ljiljana Švađumović — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-9068-2716
• Vlatka Funduk — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-7070-188X
• Nikola Krajna — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0009-0008-7628-6603
• Filip Topolnjak — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0009-0004-9137-7029
• Darko Navoj — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-8899-6524

Keywords

intravascular ultrasound, fractional flow reserve, optical coherence tomography, percutaneous coronary intervention

DOI

Full Text

Over the past decade, we have witnessed significant advancements in invasive and interventional cardiology. In practice, interventional cardiology aims to overcome the limitations of two-dimensional imaging by incorporating functional diagnostics such as IVUS (intravascular ultrasound), FFR (fractional flow reserve), and OCT (optical coherence tomography). IVUS is a diagnostic test that uses sound waves to provide a clear depiction of the inner lumen of the coronary artery, allowing for the assessment of atherosclerotic plaques. FFR is a minimally invasive procedure that measures the ratio of maximum blood flow through a narrowing compared to normal maximum flow. FFR values between <0.75 and 0.8 are considered functionally significant. This technique is highly valuable for identifying clinically relevant lesions. OCT enables high-resolution imaging of the coronary arteries by utilizing a light beam that scatters, providing interventional cardiologists with ten times better resolution than IVUS technology. Minimally invasive techniques offer a more detailed insight into vascular structure and clearer results within precise mathematical representations. Consequently, they provide more accurate and precise data, enhancing patient management and treatment strategies. This approach ensures that treatment decisions for patients with ischemic heart disease are made based solely on objective parameters, supplementing the limitations of two-dimensional X-ray imaging, image quality (graininess), and the subjective interpretation of the operator (experience or inexperience), thus forming a more comprehensive evaluation. (1-3)

Literature

1. Dey D, Slomka PJ, Leeson P, Comaniciu D, Shrestha S, Sengupta PP, et al. Artificial Intelligence in Cardiovascular Imaging: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019 March 26;73(11):1317–35. https://doi.org/10.1016/j.jacc.2018.12.054
2. Casaclang-Verzosa G, Shrestha S, Khalil MJ, Cho JS, Tokodi M, Balla S, et al. Network Tomography for Understanding Phenotypic Presentations in Aortic Stenosis. JACC Cardiovasc Imaging. 2019 February;12(2):236–48. https://doi.org/10.1016/j.jcmg.2018.11.025
3. Krueger JJ, Ewert P, Yilmaz S, Gelernter D, Peters B, Pietzner K, et al. Magnetic resonance imaging-guided balloon angioplasty of coarctation of the aorta: a pilot study. Circulation. 2006 February 28;113(8):1093–100. https://doi.org/10.1161/CIRCULATIONAHA.105.578112