University of British Columbia Advanced Cardiac Imaging Fellowship: 1) Understanding bioprosthetic leaflet degeneration in patients with and without type 2 diabetes - a pilot study, and 2) Coronary artery plaque characteristics and their association with outcomes - analyses from the ISCHEMIA trial

During the UBC Advanced Cardiac Imaging Fellowship, two research studies will be undertaken (complete abstracts included in the case for support): 1. Understanding Bioprosthetic Leaflet Degeneration in Patients with and without type 2 diabetes - a pilot study.

This study will compare bioprosthetic leaflet degeneration in patients with and without type 2 diabetes (T2D), utilising echocardiography and CT imaging from the the PARTNER 2 Registry (total N=365, 32% T2D), combined with histopathological and ex vivo 18F-NaF PET/CT imaging (N=10, 50% T2D) from explanted bioprosthetic aortic valves.

This will reveal insights into the pathophysiology and detection of structural valve degeneration in T2D. 2. Coronary Artery Plaque Characteristics and their Associations with Outcomes: analyses from the ISCHEMIA trial.

This is a post hoc analysis of the ISCHEMIA trial (a randomised trial of revascularisation versus optimal medical therapy in 5,179 patients with stable coronary artery disease and moderate or severe ischaemia).

High-risk plaque characteristics on coronary CT angiogram (CCTA, N=3,783) images will be analysed, to investigate whether in patients from the trial with adverse plaque, invasive intervention plus medical therapy reduces ischaemic events and mortality compared to medical therapy alone. This will reveal insights into which patients are likely to benefit from revascularisation.