TY - JOUR
T1 - In vivo characterization of coronary plaques
T2 - Novel findings from comparing greyscale and virtual histology intravascular ultrasound and near-infrared spectroscopy
AU - Pu, Jun
AU - Mintz, Gary S.
AU - Brilakis, Emmanouil S.
AU - Banerjee, Subhash
AU - Abdel-Karim, Abdul Rahman R
AU - Maini, Brijeshwar
AU - Biro, Sinan
AU - Lee, Jin Bae
AU - Stone, Gregg W.
AU - Weisz, Giora
AU - Maehara, Akiko
N1 - Funding Information:
Conflict of interest: G.S.M. reports receiving consulting fees from Boston Scientific and Volcano and research/grant support from Boston Scientific, InfraReDx, and Volcano. G.W.S. reports being an advisory board for Boston Scientific and Abbott Vascular, and a consultant for Medtronic, Volcano, and InfraRedx. E.S.B. reports receiving speaker honoraria from St Jude Medical and Terumo, and research support from Abbott Vascular. S.B. reports receiving speaker honoraria from St Jude Medical, Medtronic, and Johnson & Johnson and research support from Boston Scientific and The Medicines Company. B.M. reports being an advisory board for InfraRedx, Abiomed, and Medtronic, and a consultant for Abbott Vascular and St Jude Medical. A.M. reports receiving research grants from Boston Scientific and lecture fee from Volcano. J.P. reports receiving research grants from Boston Scientific China.
PY - 2012/2
Y1 - 2012/2
N2 - AimsTo test the hypothesis that near-infrared spectroscopy (NIRS) combined with intravascular ultrasound (IVUS) would provide novel information of human coronary plaque characterization.Methods and resultsGreyscale-IVUS, virtual histology (VH)-IVUS, and NIRS were compared in 131 native lesions (66 vessels) that were interrogated during catheterization by all three modalities. Greyscale-IVUS detected attenuated and echolucent plaques correlated with NIRS-detected lipid-rich areas. Attenuated plaques contained the highest NIRS probability of lipid core, followed by echolucent plaques. By VH-IVUS, 93.5 of attenuated plaques contained confluent necrotic core (NC) and were classified as VH-derived fibroatheromas (FAs). Although 75.0 of echolucent plaques were classified as VH-FAs, VH-NC was seen surrounding an echolucent zone, but not within any echolucent zone; and echolucent zones themselves contained fibrofatty and/or fibrous tissue. All calcified plaques with arc >90° contained >10 VH-NC (range 16.041.2) and were classified as calcified VH-FAs, but only 58.5 contained NIRS-detected lipid core. A positive relationship between VH-derived NC and NIRS-derived lipid core burden index was found in non-calcified plaques, but not in calcified plaques.ConclusionCombining NIRS with IVUS contributes to the understanding of plaque characterization in vivo. Further studies are warranted to determine whether combining NIRS and IVUS will contribute to the assessment of high-risk plaques to predict outcomes in patients with coronary artery disease.
AB - AimsTo test the hypothesis that near-infrared spectroscopy (NIRS) combined with intravascular ultrasound (IVUS) would provide novel information of human coronary plaque characterization.Methods and resultsGreyscale-IVUS, virtual histology (VH)-IVUS, and NIRS were compared in 131 native lesions (66 vessels) that were interrogated during catheterization by all three modalities. Greyscale-IVUS detected attenuated and echolucent plaques correlated with NIRS-detected lipid-rich areas. Attenuated plaques contained the highest NIRS probability of lipid core, followed by echolucent plaques. By VH-IVUS, 93.5 of attenuated plaques contained confluent necrotic core (NC) and were classified as VH-derived fibroatheromas (FAs). Although 75.0 of echolucent plaques were classified as VH-FAs, VH-NC was seen surrounding an echolucent zone, but not within any echolucent zone; and echolucent zones themselves contained fibrofatty and/or fibrous tissue. All calcified plaques with arc >90° contained >10 VH-NC (range 16.041.2) and were classified as calcified VH-FAs, but only 58.5 contained NIRS-detected lipid core. A positive relationship between VH-derived NC and NIRS-derived lipid core burden index was found in non-calcified plaques, but not in calcified plaques.ConclusionCombining NIRS with IVUS contributes to the understanding of plaque characterization in vivo. Further studies are warranted to determine whether combining NIRS and IVUS will contribute to the assessment of high-risk plaques to predict outcomes in patients with coronary artery disease.
KW - Coronary disease
KW - Intravascular imaging
KW - Near-infrared spectroscopy
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U2 - 10.1093/eurheartj/ehr387
DO - 10.1093/eurheartj/ehr387
M3 - Article
C2 - 22019821
AN - SCOPUS:84863013655
SN - 0195-668X
VL - 33
SP - 372
EP - 383
JO - European heart journal
JF - European heart journal
IS - 3
ER -