Angiography is the established imaging technique used routinely during all coronary diagnostic and interventional procedures. Angiograms are qualified as either single plane with one projection, single plane with two or more projections, or biplane. (Multiple projections are crucial for reconstructing heart vessels in 3-Dimensions). Angiographic projections are outlined at the bottom of the angiographic cines. Biplane angiograms are identified by consecutive cines with an equal number of frames and are preferred to single plane angiograms with multiple projections. If a case contains only single plane angiograms with one projection, then it is omitted from the study for not following protocol.
Intravascular Ultrasound (IVUS) is a technique providing cross-sectional, high-resolution tomographic images of the arterial wall. This technique yields qualitative and quantitative assessment of the extent and severity of arterial atherosclerotic diseases. Intravascular ultrasound (IVUS) pullbacks are qualified as either gray scale or virtual histology.
Optical Coherence Tomography (OCT), a light-based intravascular imaging modality, permits the in vivo visualization of biologic tissues with an unmatched resolution of 15 microns. Optical coherence tomography (OCT) pullbacks are screened for image clarity, ie. no skipping, clear defined lumen.
Once screened, data are stored both onsite in a username and password protected storage server and on Emory BOX (HIPAA compliant file sharing software) organized by case ID. Complete cases are chosen at random. The clinical division works to reconstruct the wire in 3 dimensions using Medis QAngio XA 3D Straight and Bifurcation (3D QCA software). Additionally, contours are added to IVUS pullbacks that outline both the vessel boundaries and the lumen boundaries using INDEC Echoplaque 4.0.27 (VH-IVUS software). IVUS and angiographic are co-registered using branch points along the vessel for reference. DAT,XML, and TIFF files of the IVUS pullback along with the Medis reconstructed wires are sent to the engineering division where computational fluid models of the vessels are created.
Computational fluid dynamic (CFD) simulations to calculate WSS values have been validated and used extensively in our laboratory. Following imaging and hemodynamic data acquisition, 3-dimensional (3D) coronary geometries are reconstructed and a mesh is created based on the geometry. A set of conditions (e.g., incompressible Newtonian fluid, pulsatile inlet velocity values applied at the inlet face as a series of axisymmetric blunt core profiles, traction-free boundary conditions applied at all outlets, and a no-slip boundary condition applied at the vessel wall) are employed in the finite volume method used for solving the Navier-Stokes equations. For OCT derived reconstructions, the wire is again reconstructed in 3 dimensions. OCT and the wire are also co-registered with branch points along the vessel and sent to the mathematical division to create the computational fluid dynamic models.
Core Lab Principals
Habib Samady, MD, FACC
Professor of Medicine
Director, Interventional Cardiology
Emory University Hospitals Director
Emory Cardiovascular Imaging & Biomechanical Core Laboratory
Spencer B. King III, MD, MACC
Alessandro Veneziani, PhD
Don P. Giddens, PhD
Professor, Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory
Core Lab Staff
Bil D. Goghs, MD, PhD, FACC (Vasileios D. Gkogkas)
Luke Timmins, PhD
Marina Piccinelli, PhD
Olivia Y. Hung, MD, PhD
Parham Eshtehardi, MD
David Molony, PhD
Boyi Yang, MS, PhD
Teresa Stilly, MBA
Cardiology Research Interns
Visiting Scholars
Sung Ahn, M.D.
Jon Suh, M.D
Publications
Please click on a core team member to find a list of their publications.
Lead Investigator
Pre clinical research - Vascular Reparative Therapy
Vasomotor Function Comparative Assessment at 1-, 2-, 3-, and 4-years of Vessels Treated with the Absorb Everolimus- Eluting Bioresorbable Vascular Scaffold and the Xience V Everolimus-Eluting Metallic stent in Porcine Coronary Arteries.
Clinical research: ABSORB III Imaging sub-study
Evaluation and Comparison of Three-Dimensional Wall Shear Stress Patterns And Neointimal Healing Following Percutaneous Coronary Intervention With the Absorb Everolimus-Eluting Bioresorbable Vascular Scaffold Compared to the Xience V Everolimus-Eluting Metallic Stent.
To evaluate the effects of the fully bioresorbable stent system, Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, Calif. USA) and the metallic device: XIENCE everolimus eluting stent (Abbott Vascular, Santa Clara, Calif. USA) on the local hemodynamics and vessel compliance in subjects entered into the imaging sub-study of the ABSORB randomized clinical trial (ABSORB III) and prospectively correlate these biomechanical characteristics to clinical outcomes.
Shear-Stent study
Conformability Assessment of Resolute Integrity Zotarolimus-Eluting Stent versus XIENCE Xpedition Everolimus-Eluting Stent
The aim of this study is to calculate OCT-derived WSS within R-ZES and X-EES stents and relate differences in regional in-stent WSS to neo-intimal tissue coverage assessed by OCT at one year and to calculate IVUS-derived WSS at the R-ZES and X-EES stent edges and relate differences in regional WSS at stent edges to change in plaque area at one year in patients undergoing PCI to angulated coronary arteries.