Department of Electrical Engineering, Columbia University, New York, NY.
Department of Pathology, Columbia University Medical Center, New York, NY.
J Cardiovasc Electrophysiol. 2019 Dec;30(12):2950-2959. doi: 10.1111/jce.14255. Epub 2019 Nov 5.
Optical coherence tomography (OCT) has the potential to provide real-time imaging guidance for atrial fibrillation ablation, with promising results for lesion monitoring. OCT can also offer high-resolution imaging of tissue composition, but there is insufficient cardiac OCT data to inform the use of OCT to reveal important tissue architecture of the human left atrium. Thus, the objective of this study was to define OCT imaging data throughout the human left atrium, focusing on the distribution of adipose tissue and fiber orientation as seen from the endocardium.
Human hearts (n = 7) were acquired for imaging the left atrium with OCT. A spectral-domain OCT system with 1325 nm center wavelength, 6.5 μm axial resolution, 15 μm lateral resolution, and a maximum imaging depth of 2.51 mm in the air was used. Large-scale OCT image maps of human left atrial tissue were developed, with adipose thickness and fiber orientation extracted from the imaging data. OCT imaging showed scattered distributions of adipose tissue around the septal and pulmonary vein regions, up to a depth of about 0.43 mm from the endocardial surface. The total volume of adipose tissue detected by OCT over one left atrium ranged from 1.42 to 28.74 mm . Limited fiber orientation information primarily around the pulmonary veins and the septum could be identified.
OCT imaging could provide adjunctive information on the distribution of subendocardial adipose tissue, particularly around thin areas around the pulmonary veins and septal regions. Variations in OCT-detected tissue composition could potentially assist ablation guidance.
光学相干断层扫描（OCT）有可能为房颤消融提供实时成像指导，在监测病变方面有很好的效果。OCT 还可以提供组织成分的高分辨率成像，但目前还没有足够的心脏 OCT 数据来告知使用 OCT 揭示人类左心房重要的组织结构。因此，本研究的目的是定义整个左心房的 OCT 成像数据，重点关注从心内膜观察到的脂肪组织分布和纤维方向。
采集人类心脏（n=7）用于左心房 OCT 成像。使用具有 1325nm 中心波长、6.5μm 轴向分辨率、15μm 横向分辨率和在空气中最大成像深度为 2.51mm 的光谱域 OCT 系统。开发了人类左心房组织的大规模 OCT 图像图谱，并从成像数据中提取了脂肪厚度和纤维方向。OCT 成像显示，脂肪组织在间隔和肺静脉区域周围呈散在分布，从心内膜表面深度可达约 0.43mm。通过 OCT 检测到的一个左心房的总脂肪组织体积范围为 1.42 至 28.74mm³。主要在肺静脉和间隔周围可以识别到有限的纤维方向信息。
OCT 成像可以提供心内膜下脂肪组织分布的辅助信息，特别是在肺静脉和间隔区域周围较薄的区域。OCT 检测到的组织成分的变化可能有助于消融指导。
