Cardiovascular Disease: China's Leading Health Killer and the Role of OCT-Guided Interventional Diagnosis and Treatment
Since the onset of winter, the incidence of cardiovascular diseases has once again peaked, with cardiology departments in hospitals across China overwhelmed by patients. RecentlyVCBeat (WeChat ID: vcbeat)Reporters have learned that cardiovascular departments at several hospitals, including Beijing Fuwai Hospital, the Chinese PLA General Hospital, and Xi’an Xijing Hospital, are experiencing severe appointment backlogs.
According to statistics from relevant authorities, between 1990 and 2015, the incidence and mortality rates of cardiovascular diseases among urban and rural residents in China were significantly higher than those of cancer and other types of diseases, consistently showing a rapid upward trend. Cardiovascular disease has become the “leading killer” threatening the life and health of the Chinese population. Additionally, the recently released “China Cardiovascular Health Index (2017)” indicates thatCurrently, 290 million people in China suffer from cardiovascular diseases of varying severity. Approximately 3.5 million deaths are attributed to cardiovascular diseases annually, meaning that, on average, one person dies from a cardiovascular disease every 10 seconds.
“Among disease-related deaths in China, two out of every five are caused by cardiovascular diseases.” Experts from the National Expert Committee on Cardiovascular Diseases stated that the prevalence of cardiovascular risk factors in China is unprecedented in both its rate of increase and scale, and the current explosive trend is expected to continue for at least the next decade.
Driven by this trend, the total hospitalization costs for cardiovascular and cerebrovascular diseases in China are also rising rapidly. Since 2004, the average annual growth rate of expenditure on these conditions has far exceeded the GDP growth rate. According to health data released by industry research firms, the direct annual treatment costs for cardiovascular and cerebrovascular diseases in China have surpassed RMB 300 billion.
Cardiovascular diseases mainly include coronary heart disease (such as myocardial infarction), cerebrovascular disease (such as stroke), hypertension, peripheral vascular disease, rheumatic heart disease, congenital heart disease, heart failure, and cardiomyopathy. Among these, a broad category of diseases caused by vascular stenosis and occlusion due to hyperlipidemia, hyperviscosity, and atherosclerosis—leading to secondary ischemia or hemorrhage in the heart, brain, and systemic tissues—is particularly common. These conditions pose the greatest threat to middle-aged and elderly individuals over 50 years old, characterized by high prevalence, high disability rates, and high mortality.
“Even with the most advanced diagnostic and therapeutic technologies currently available, more than 50% of cardiovascular disease patients still die despite receiving medical care.” Experts in the cardiovascular discipline at the Fourth Military Medical University have expressed grave concern over this issue. He introduced that,The current main treatment methods for cardiovascular diseases include pharmacological therapy, interventional therapy, and surgical therapy.“Pharmacological treatments take effect relatively slowly; while they can alleviate patients' current symptoms, they often fail to achieve a cure. The primary form of surgical intervention is coronary artery bypass grafting (CABG), which yields significant therapeutic benefits but involves complex procedures and imposes a substantial burden on patients.”
With continuous innovation and development in human medical technology, interventional therapy is being increasingly adopted by both physicians and patients. Experts told reporters,Interventional therapy refers to a procedure in which a small puncture is made in an artery of the patient’s arm or leg, through which a guidewire and a microcatheter are inserted. The guidewire is advanced through the vasculature to the site of occlusion within the coronary arteries. Balloons or mesh stents are then deployed over the guidewire to dilate the obstructed segment, restore coronary blood flow, and thereby achieve therapeutic outcomes.
“This therapy offers numerous advantages, including rapid action, non-invasiveness, minimal trauma, quick recovery, low cost, and repeatability. It can swiftly address coronary artery stenosis and alleviate myocardial ischemia, thereby significantly reducing patient mortality.” The expert provided a vivid example, noting that cardiovascular patients undergoing interventional therapy experience fewer complications, benefit from convenient postoperative hemostatic compression, and can walk out of the operating room immediately after the procedure, with their daily lives remaining largely unaffected.
It is also understood that,The significant curative effects of interventional therapy rely on the support of high-performance imaging technologies.Currently available imaging techniques include coronary angiography (CAG), coronary CT, cardiac MRI, intravascular ultrasound (IVUS), and intravascular optical coherence tomography (OCT), with OCT being the latest generation and most cost-effective among them.
The principle of OCT is to utilize a high-precision optical interference system combined with an infrared light source, and through rapid scanning by a fiber-optic intravascular imaging catheter, obtain two-dimensional cross-sectional images of blood vessels and three-dimensional endoluminal reconstructed images. OCT offers extremely high resolution, reaching below 10 micrometers, which enables the visualization of tissue structures as small as one-tenth the diameter of a human hair. This prominent feature allows OCT to play an increasingly important role in the diagnosis and treatment of cardiovascular diseases.
“As the “histological microscope” within the human body, optical coherence tomography (OCT) has become an ideal tool for assessing vulnerable plaques and evaluating the efficacy of stent therapy, and it is currently the only technique capable of in vivo measurement of plaque fibrous cap thickness.“Chen Yundai, a renowned cardiovascular expert and Director of the Department of Cardiology at the Chinese PLA General Hospital, stated in an interview, ‘In the pre-onset phase, OCT imaging can effectively diagnose borderline lesions, making early screening for cardiovascular and other diseases a reality. During the mid-treatment phase, OCT technology can assess the immediate outcomes following stent implantation.’”
Chen Yundai introduced that researchers from Harvard Medical School in the United States once performed OCT examinations on PCI patients to evaluate vascular dissection, tissue prolapse, stent apposition, and stent asymmetry, and compared the results with IVUS. A total of 42 stents in 39 patients were imaged, with no complications observed.
“In the era of drug-eluting stents, using OCT to evaluate the therapeutic efficacy of stent implantation and participate in postoperative follow-up is irreplaceable by other diagnostic modalities,” stated Chen Yundai.
In recent years, many globally leading medical device companies have engaged in fierce competition in the field of OCT imaging, making this niche a new hotspot for competition in the medical device industry. Among them, St. Jude Medical (USA) and Terumo Corporation (Japan) are the most prominent.
In China, a tech startup team with years of deep expertise in interventional imaging diagnosis and treatment"Glimmer Medical“Highly regarded within the industry. The team has alreadyDeveloped China's first clinical interventional Optical Coherence Tomography (OCT) system, achieving an endoscopic imaging catheter diameter of 0.86 mm and breaking the global record of 0.92 mm.The system has entered the clinical trial phase for registration as an innovative medical device and is expected to obtain certification and be launched on the market in early 2019, thereby benefiting the general public in China.