NIRS and IVUS for Characterization of Atherosclerosis in Patients Undergoing Coronary Angiography

Brugaletta, Salvatore; García‐García, Héctor M.; Serruys, Patrick W.; Boer, Sanneke de; Ligthart, Jürgen; Gomez‐Lara, Josep; Witberg, Karen; Diletti, Roberto; Wykrzykowska, Joanna J.; Geuns, Robert‐Jan van; Schultz, Carl; Regar, Evelyn; Duckers, Henricus J.; Mieghem, Nicolas Van; Jaegere, Peter de; Madden, Sean; Muller, James E.; Steen, Antonius F.W. van der; Giessen, Wim J. van der; Boersma, Eric

doi:10.1016/j.jcmg.2011.03.013

Cited by 80 publications

(47 citation statements)

References 24 publications

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“…Ultrasound based "virtual histology" 81 , Raman spectroscopy 82 , thermography 83 near-infrared spectroscopy 84 or optical coherence tomography 85 86 , and a variety of molecular imaging strategies have all undergone development seeking to detect the inflammatory thin cap fibroatheroma, the type of plaque supposed to entail a high risk for a thrombotic event based on the pathological observations from the last century. Non-invasive magnetic resonance imaging can identify intraplaque hemorrhage, a plaque characteristic that may predict future adverse cardiovascular events and progression of luminal narrowing 87 60 .…”

Section: Imaging Of the Atherosclerotic Plaque At Riskmentioning

confidence: 99%

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

2016

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The concept of "the vulnerable plaque" originated from pathological observations in patients who succumbed to fatal acute coronary syndromes. This recognition spawned a generation of research that led to achievement of considerable understanding of how complicated atherosclerotic plaques form and precipitate thrombotic events.In current practice, an increasing number of patients present with non ST-elevation myocardial infarction (NSTEMI) rather than myocardial infarction (MI) with ST-elevation Key points• An increasing number of patients presenting with myocardial infarction (MI) are diagnosed with a non ST-elevated myocardial infarction (NSTEMI) rather than a MI with ST-elevation (STEMI) and consequently survive their first event.• The shift in the clinical presentations of the acute coronary syndromes mandates a critical reassessment of the underlying mechanisms and the concept of the 3 vulnerable plaque.• The change in clinical presentation and warrant critical re-assessment of currently applied cardiovascular risk scores, pre-clinical experiments, and the usefulness of population data and samples harvested before the application of current preventive interventions.4

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Section: Imaging Of the Atherosclerotic Plaque At Riskmentioning

confidence: 99%

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

2016

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Section: Near-infrared Spectroscopy (Nirs)mentioning

confidence: 93%

“…It was previously shown that large plaque area measured by grayscale IVUS was more often associated with lipid accumulation/LCP detected by NIRS [19,80]. However, Brugaletta et al [80] found a weak correlation between the VH necrotic core content of the plaque and the block chemogram probability values (r =0.149), which did not improve after correction for the presence of calcium. In a larger study performed in 131 plaques of 66 vessels, in which 31 plaques (26.7%) were attenuated, the relation between VH-derived percentage necrotic core and NIRS-derived LCBI was not significant (r = 0.16, P = 0.110) [81].…”

Section: Near-infrared Spectroscopy (Nirs)mentioning

confidence: 93%

Near-Infrared Spectroscopy (NIRS): A Novel Tool for Intravascular Coronary Imaging

Bertrand¹,

Lavoie-L'Allier²,

Jean-ClaudeTardif³

2017

Developments in Near-Infrared Spectroscopy

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Acute coronary syndrome (ACS) arising from plaque rupture is the leading cause of mortality worldwide. Near-infrared spectroscopy (NIRS) combined with intravascular ultrasound (NIRS-IVUS) is a novel catheter-based intravascular imaging modality that provides a chemogram of the coronary artery wall, which enables the detection of lipid core and specific quantification of lipid accumulation measured as the lipid-core burden index (LCBI) in patients undergoing coronary angiography. Recent studies have shown that NIRS-IVUS can identify vulnerable plaques and vulnerable patients associated with increased risk of adverse cardiovascular events, whereas an increased coronary plaque LCBI may predict a higher risk of future cardiovascular events and periprocedural events. NIRS is a promising tool for the detection of vulnerable plaques in CAD patients, PCI-guidance procedures, and assessment of lipid-lowering therapies. Previous trials have evaluated the impact of statin therapy on coronary NIRS defined lipid cores, whereas NIRS could further be used as a surrogate end point of future ACS in phase II clinical trials evaluating novel anti-atheromatous drug therapies. Multiple ongoing studies address the different potential clinical applications of NIRS-IVUS imaging as a valuable tool for coronary plaque characterization and predictor of future coronary events in CAD patients.

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“…32- 34 The development of NIRS for use in human coronary arteries has been a complex process requiring more than 15 years. The initial studies from numerous groups thoroughly demonstrated NIRS as a valid methodology for measuring the chemical components of atherosclerotic plaque.…”

Section: Tissue Characterization Using Intracoronary Nirsmentioning

confidence: 99%

Assessment of Plaque Composition by Intravascular Ultrasound and Near-Infrared Spectroscopy

Brugaletta

Sabaté

2014

Circ J

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Atherosclerosis is the main cause of coronary artery disease (CAD), which is today the leading cause of death worldwide and will continue to be the first in the world in 2030. Vulnerable coronary plaques are usually characterized by a high content of necrotic core, a thin inflamed fibrous cap (intense accumulation of macrophages) and scarce presence of smooth muscle cells. None of these characteristics can be estimated by coronary angiography, which on the contrary underestimates the magnitude of atherosclerotic burden, particularly in earlier stage disease when positive vascular remodeling may allow "normal" lumen caliber despite substantial vascular wall plaque. The recognition of the ubiquity of substantial but non-flow limiting lesions that may be at high risk for subsequent plaque rupture has resulted in a paradigm shift in thinking about the pathophysiology of CAD, with the focus no longer solely on the degree of arterial luminal narrowing. This growing need for more information about coronary atherosclerosis in order to identify patients and lesions at risk for complications during PCI and for future adverse cardiac events has been the primary impetus for the development of novel intracoronary imaging methods able to detect plaque composition, in particular presence of a necrotic core/lipid pool, such as intravascular ultrasound virtual histology and near-infrared spectroscopy. These imaging technologies and their clinical and clinical/research applications are discussed in detail. (Circ J 2014; 78: 1531 -1539

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NIRS and IVUS for Characterization of Atherosclerosis in Patients Undergoing Coronary Angiography

Abstract: Larger plaque area by grayscale IVUS was more often associated with either elevated percentage VH-NC or LCP by NIRS; however, the correlation between the detection of LCP by NIRS and necrotic core by VH is weak.

Cited by 80 publications

References 24 publications

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

Near-Infrared Spectroscopy (NIRS): A Novel Tool for Intravascular Coronary Imaging

Assessment of Plaque Composition by Intravascular Ultrasound and Near-Infrared Spectroscopy

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