ICUS Weekly News Monitor 6-5-2018


ICUS Weekly News Monitor

05 June 2018 - 9 am Eastern

 
 
 
  1. Dovepress,  Perfluorooctylbromide nanoparticles for ultrasound imaging and drug delivery,  May 25, 2018   Authors:  Xiao Li, et al
  2. EuroIntervention,  Association between fractional flow reserve, instantaneous wave-free ratio and dobutamine stress echocardiography in patients with stable coronary artery disease,   March 20, 2018     Authors:  Vasileios F. Panoulas

Dovepress

Volume 2018:13 Pages 3053—3067; DOI https://doi.org/10.2147/IJN.S164905

Perfluorooctylbromide nanoparticles for ultrasound imaging and drug delivery

May 25, 2018

Authors: Xiao Li, Zhongguo Sui, Xin Li, Wen Xu, Qie Guo, Jialin Sun, Fanbo Jing

Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China

Abstract:

Perfluorooctylbromide nanoparticles (PFOB NPs) are a type of multifunctional nanotechnology that has been studied for various medical applications. Commercial ultrasound contrast agents (UCAs) suffer from the following limitations: short half-lives in vivo, high background signal and restricted distribution in the vascular circulation due to their micrometer dimensions. PFOB NPs are new potential UCAs that persist for long periods in the circulatory system, possess a relatively stable echogenic response without increasing the background signal and exhibit lower acoustic attenuation than commercial UCAs. Furthermore, PFOB NPs may also serve as drug delivery vehicles in which drugs are dissolved in the outer lipid or polymer layer for subsequent delivery to target sites in site-targeted therapy. The use of PFOB NPs as carriers has the potential advantage of selectively delivering payloads to the target site while improving visualization of the site using ultrasound (US) imaging. Unfortunately, the application of PFOB NPs to the field of ultrasonography has been limited because of the low intensity of US reflection. Numerous researchers have realized the potential use of PFOB NPs as UCAs and thus have developed alternative approaches to apply PFOB NPs in ultrasonography. In this article, we review the latest approaches for using PFOB NPs to enhance US imaging in vivo. In addition, this article emphasizes the application of PFOB NPs as promising drug delivery carriers for cancer and atherosclerosis treatments, as PFOB NPs can transport different drug payloads for various applications with good efficacy. We also note the challenges and future study directions for the application of PFOB NPs as both a delivery system for therapeutic agents and a diagnostic agent for ultrasonography.

 
 
 
 
 
 

EuroIntervention

Association between fractional flow reserve, instantaneous wave-free ratio and dobutamine stress echocardiography in patients with stable coronary artery disease.

March 20, 2018

Authors: Vasileios F. Panoulas1,2,3*, MD, PhD; Kalliopi Keramida1, MD; Olga Boletti1, MD; Michail I. Papafaklis1, MD, PhD; Dimitris Flessas1, MD; Maria Petropoulou1, MD; Petros Nihoyannopoulos1,2, MD

1. Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom; 2. Division of Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, United Kingdom; 3. Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom

This paper also includes supplementary data published online at: http://www.pcronline.com/eurointervention/131st_issue/318

Abstract

Aims

The association between fractional flow reserve (FFR) and dobutamine stress echocardiography(DSE) in real-world stable angina patients is scant and controversial whereas no such comparison exists with instantaneous wave-free ratio (iFR). The current retrospective study aimed to investigate the associations among these modalities in patients with stable coronary artery disease (CAD) and intermediate coronary lesions.

Methods and results

We studied 62 consecutive stable angina patients who underwent DSE and subsequently coronary angiography with FFR (in all 62) and iFR (in 46/62 patients) assessment of intermediate single-vessel lesions between 2014 and 2015. Using receiver operating characteristic (ROC) curves we sought to identify the optimal FFR and iFR cut-off points with the highest discriminative power to predict

the DSE result. The kappa coefficient was used to assess the agreement between FFR, iFR and DSE. Themean age of the study cohort was 63.5±12 years and 35 (56.5%) were males. Thirteen (21%) lesions were adjudicated as causing reversible ischaemia on DSE. Using ROC (FFR predicting DSE result), the area under the curve was 0.952 (95% CI: 0.902 to 1), whereas for iFR it was 0.743 (95% CI: 0.560 to 0.927), pAUC comparison=0.03. The optimal FFR cut-off point predicting positive DSE was 0.80. There was strong agreement between DSE and FFR (kappa 0.682, p<0.001). There was only modest agreement between iFR and DSE (kappa 0.258, p=0.068) using a cut-off value of 0.9.

Conclusions

In patients referred for evaluation of stable CAD, there was good agreement between DSE and FFR (87%) but less so with iFR (71.7%).

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