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      The Evolution of Data Fusion Methodologies Developed to Reconstruct Coronary Artery Geometry From Intravascular Imaging and Coronary Angiography Data: A Comprehensive Review

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          Abstract

          Understanding the mechanisms that regulate atherosclerotic plaque formation and evolution is a crucial step for developing treatment strategies that will prevent plaque progression and reduce cardiovascular events. Advances in signal processing and the miniaturization of medical devices have enabled the design of multimodality intravascular imaging catheters that allow complete and detailed assessment of plaque morphology and biology. However, a significant limitation of these novel imaging catheters is that they provide two-dimensional (2D) visualization of the lumen and vessel wall and thus they cannot portray vessel geometry and 3D lesion architecture. To address this limitation computer-based methodologies and user-friendly software have been developed. These are able to off-line process and fuse intravascular imaging data with X-ray or computed tomography coronary angiography (CTCA) to reconstruct coronary artery anatomy. The aim of this review article is to summarize the evolution in the field of coronary artery modeling; we thus present the first methodologies that were developed to model vessel geometry, highlight the modifications introduced in revised methods to overcome the limitations of the first approaches and discuss the challenges that need to be addressed, so these techniques can have broad application in clinical practice and research.

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          Most cited references53

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          Identification of patients and plaques vulnerable to future coronary events with near-infrared spectroscopy intravascular ultrasound imaging: a prospective, cohort study

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            Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study

            The CLIMA study, on the relationship between coronary plaque morphology of the left anterior descending artery and twelve months clinical outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. From January 2013 to December 2016, 1003 patients undergoing OCT evaluation of the untreated proximal left anterior descending coronary artery in the context of clinically indicated coronary angiogram were prospectively enrolled at 11 independent centres (clinicaltrial.gov identifier NCT02883088). At 1-year, the primary clinical endpoint was observed in 37 patients (3.7%). In a total of 1776 lipid plaques, presence of MLA 180° (HR 2.4, 95% CI 1.2–4.8), and OCT-defined macrophages (HR 2.7, 95% CI 1.2–6.1) were all associated with increased risk of the primary endpoint. The pre-specified combination of plaque features (simultaneous presence of the four OCT criteria in the same plaque) was observed in 18.9% of patients experiencing the primary endpoint and was an independent predictor of events (HR 7.54, 95% CI 3.1–18.6). The simultaneous presence of four high-risk OCT plaque features was found to be associated with a higher risk of major coronary events.
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              Role of biomechanical forces in the natural history of coronary atherosclerosis.

              Atherosclerosis remains a major cause of morbidity and mortality worldwide, and a thorough understanding of the underlying pathophysiological mechanisms is crucial for the development of new therapeutic strategies. Although atherosclerosis is a systemic inflammatory disease, coronary atherosclerotic plaques are not uniformly distributed in the vascular tree. Experimental and clinical data highlight that biomechanical forces, including wall shear stress (WSS) and plaque structural stress (PSS), have an important role in the natural history of coronary atherosclerosis. Endothelial cell function is heavily influenced by changes in WSS, and longitudinal animal and human studies have shown that coronary regions with low WSS undergo increased plaque growth compared with high WSS regions. Local alterations in WSS might also promote transformation of stable to unstable plaque subtypes. Plaque rupture is determined by the balance between PSS and material strength, with plaque composition having a profound effect on PSS. Prospective clinical studies are required to ascertain whether integrating mechanical parameters with medical imaging can improve our ability to identify patients at highest risk of rapid disease progression or sudden cardiac events.
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                Author and article information

                Contributors
                Journal
                Front Cardiovasc Med
                Front Cardiovasc Med
                Front. Cardiovasc. Med.
                Frontiers in Cardiovascular Medicine
                Frontiers Media S.A.
                2297-055X
                31 March 2020
                2020
                : 7
                : 33
                Affiliations
                [1] 1Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust , London, United Kingdom
                [2] 2Institute of Cardiovascular Sciences, University College London , London, United Kingdom
                [3] 3Centre for Cardiovascular Medicine and Device Innovation, Queen Mary University London , London, United Kingdom
                [4] 4Faculty of Medicine, National Heart & Lung Institute, Imperial College London , London, United Kingdom
                [5] 5Department of Radiology, Leiden University Medical Center , Leiden, Netherlands
                [6] 6Erasmus University Medical Center , Rotterdam, Netherlands
                [7] 7Department of Mechanical Engineering, University College London , London, United Kingdom
                Author notes

                Edited by: Sebastian Kelle, Deutsches Herzzentrum Berlin, Germany

                Reviewed by: Johan Reiber, Leiden University, Netherlands; Antonios Karanasos, Hippokration General Hospital, Greece

                *Correspondence: Christos V. Bourantas cbourantas@ 123456gmail.com

                This article was submitted to Cardiovascular Imaging, a section of the journal Frontiers in Cardiovascular Medicine

                Article
                10.3389/fcvm.2020.00033
                7136420
                32296713
                7b149cea-b370-4738-be84-3d7ed7f64265
                Copyright © 2020 Kilic, Safi, Bajaj, Serruys, Kitslaar, Ramasamy, Tufaro, Onuma, Mathur, Torii, Baumbach and Bourantas.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 29 November 2019
                : 21 February 2020
                Page count
                Figures: 6, Tables: 1, Equations: 0, References: 83, Pages: 13, Words: 9514
                Categories
                Cardiovascular Medicine
                Review

                hybrid intravascular imaging,data fusion methodologies,3d reconstruction,coronary artery modeling,coronary angiography

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