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Near-Infrared Spectroscopy Enhances Intravascular Ultrasound Assessment of Vulnerable Coronary Plaque: A Combined Pathological and In Vivo Study.
Puri, Rishi; Madder, Ryan D; Madden, Sean P; Sum, Stephen T; Wolski, Kathy; Muller, James E; Andrews, Jordan; King, Karilane L; Kataoka, Yu; Uno, Kiyoko; Kapadia, Samir R; Tuzcu, E Murat; Nissen, Steven E; Virmani, Renu; Maehara, Akiko; Mintz, Gary S; Nicholls, Stephen J.
Afiliação
  • Puri R; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Madder RD; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Madden SP; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Sum ST; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Wolski K; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Muller JE; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Andrews J; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • King KL; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Kataoka Y; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Uno K; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Kapadia SR; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Tuzcu EM; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Nissen SE; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Virmani R; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Maehara A; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Mintz GS; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
  • Nicholls SJ; From the Cleveland Clinic Coordinating Center for Clinical Research (C5R) (R.P., K.W., K.L.K., K.U., S.E.N.), and Department of Cardiovascular Medicine (R.P., S.R.K., E.M.T., S.E.N.), Cleveland Clinic, OH; Department of Medicine, University of Adelaide, South Australia (R.P., S.J.N.); Frederik Meije
Arterioscler Thromb Vasc Biol ; 35(11): 2423-31, 2015 Nov.
Article em En | MEDLINE | ID: mdl-26338299
ABSTRACT

OBJECTIVES:

Pathological studies demonstrate the dual significance of plaque burden (PB) and lipid composition for mediating coronary plaque vulnerability. We evaluated relationships between intravascular ultrasound (IVUS)-derived PB and arterial remodeling with near-infrared spectroscopy (NIRS)-derived lipid content in ex vivo and in vivo human coronary arteries. APPROACH AND

RESULTS:

Ex vivo coronary NIRS and IVUS imaging was performed through blood in 116 coronary arteries of 51 autopsied hearts, followed by 2-mm block sectioning (n=2070) and histological grading according to modified American Heart Association criteria. Lesions were defined as the most heavily diseased 2-mm block per imaged artery on IVUS. IVUS-derived PB and NIRS-derived lipid core burden index (LCBI) of each block and lesion were analyzed. Block-level analysis demonstrated significant trends of increasing PB and LCBI across more complex atheroma (Ptrend <0.001 for both LCBI and PB). Lesion-based analyses demonstrated the highest LCBI and remodeling index within coronary fibroatheroma (Ptrend <0.001 and 0.02 versus all plaque groups, respectively). Prediction models demonstrated similar abilities of PB, LCBI, and remodeling index for discriminating fibroatheroma (c indices 0.675, 0.712, and 0.672, respectively). A combined PB+LCBI analysis significantly improved fibroatheroma detection accuracy (c index 0.77, P=0.028 versus PB; net-reclassification index 43%, P=0.003), whereas further adding remodeling index did not (c index 0.80, P=0.27 versus PB+LCBI). In vivo comparisons of 43 age- and sex-matched patients (to the autopsy cohort) undergoing combined NIRS-IVUS coronary imaging yielded similar associations to those demonstrated ex vivo.

CONCLUSIONS:

Adding NIRS to conventional IVUS-derived PB imaging significantly improves the ability to detect more active, potentially vulnerable coronary atheroma.
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Texto completo: 1 Temas: ECOS / Aspectos_gerais Bases de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Ultrassonografia de Intervenção / Espectroscopia de Luz Próxima ao Infravermelho / Vasos Coronários / Placa Aterosclerótica / Lipídeos Tipo de estudo: Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Arterioscler Thromb Vasc Biol Assunto da revista: ANGIOLOGIA Ano de publicação: 2015 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Temas: ECOS / Aspectos_gerais Bases de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Ultrassonografia de Intervenção / Espectroscopia de Luz Próxima ao Infravermelho / Vasos Coronários / Placa Aterosclerótica / Lipídeos Tipo de estudo: Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Arterioscler Thromb Vasc Biol Assunto da revista: ANGIOLOGIA Ano de publicação: 2015 Tipo de documento: Article