Variability in the measurement of intracoronary ultrasound images: implicatioNs for the identification of atherosclerotic plaque regression

Foster, Gary P.; Mittleman, Murray A.; Koch, Michael; Abela, George S.; Zarich, Stuart

doi:10.1002/clc.4960200105

Cited by 18 publications

(13 citation statements)

References 37 publications

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“…This may lead to vasodilation and structural vessel wall remodelling 107. Baseline vasomotor tone is also decreased in atherosclerotic vessels by a functional mechanism 108…”

Section: Reactive Oxidant Species Formation and Cardiovascular Diseasementioning

confidence: 99%

Oxidative Stress as a Mediator of Cardiovascular Disease

Elahi¹,

Kong²,

Matata³

2009

Oxidative Medicine and Cellular Longevity

308

225

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During physiological processes molecules undergo chemical changes involving reducing and oxidizing reactions. A molecule with an unpaired electron can combine with a molecule capable of donating an electron. The donation of an electron is termed as oxidation whereas the gaining of an electron is called reduction. Reduction and oxidation can render the reduced molecule unstable and make it free to react with other molecules to cause damage to cellular and sub-cellular components such as membranes, proteins and DNA. In this paper, we have discussed the formation of reactive oxidant species originating from a variety of sources such as nitric oxide (NO) synthase (NOS), xanthine oxidases (XO), the cyclooxygenases, nicotinamide adenine dinucleotide phosphate (NAD(P)H) oxidase isoforms and metal-catalyzed reactions. In addition, we present a treatise on the physiological defences such as specialized enzymes and antioxidants that maintain reduction-oxidation (redox) balance. We have also given an account of how enzymes and antioxidants can be exhausted by the excessive production of reactive oxidant species (ROS) resulting in oxidative stress/nitrosative stress, a process that is an important mediator of cell damage. Important aspects of redox imbalance that triggers the activity of a number of signaling pathways including transcription factors activity, a process that is ubiquitous in cardiovascular disease related to ischemia/reperfusion injury have also been presented.

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“…This may lead to vasodilation and structural vessel wall remodelling 107. Baseline vasomotor tone is also decreased in atherosclerotic vessels by a functional mechanism 108…”

Section: Reactive Oxidant Species Formation and Cardiovascular Diseasementioning

confidence: 99%

Oxidative Stress as a Mediator of Cardiovascular Disease

Elahi¹,

Kong²,

Matata³

2009

Oxidative Medicine and Cellular Longevity

308

225

View full text Add to dashboard Cite

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“…Intravascular ultrasound (IVUS) provides precise and highly reproducible measurements of coronary vessel dimensions [2][3][4][5][6][7]; it is increasingly used as a major endpoint in serial pharmacological progression-regression trials [8][9][10][11][12], drug eluting stent trials [13], and studies of coronary vascular remodeling [14,15]. Despite the high reproducibility of measurements by an individual IVUS system [6,7], there is a substantial variability of measurements obtained from different IVUS devices [16][17][18][19][20][21][22].…”

mentioning

confidence: 99%

Dedicated calibration formulas permit correction of differences between measurements by different IVUS devices as demonstrated in atherosclerotic human coronary arteries in vitro

Hartmann

Birgelen

Mintz

et al. 2006

Int J Cardiovasc Imaging

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Serial intravascular ultrasound (IVUS) measurements of coronary vessel dimensions are major endpoints of studies focusing on pharmacological interventions, efficiency of drug eluting stents, and vascular remodeling. In serial studies measurement variability among different IVUS devices may cause substantial misinterpretation and error. We analyzed 33 human coronary plaques in vitro using two different IVUS systems (mechanical IVUS system with a 40 MHz Atlantis SR catheter; solid-state electronic IVUS system with a 20 MHz Invision catheter) and repeatedly measured the total vessel, lumen, and plaque + media cross-sectional area and plaque burden (plaque + media area divided by total vessel area). Between the "raw" measurements made by the two devices, there was a significant difference for both plaque + media area (2.35+/-1.86 mm(2), P < 0.01) and plaque burden (5.39+/-3.68%, P < 0.05). Measurements were then corrected by use of recently introduced calibration formulas; as a result the differences decreased significantly for all IVUS parameters measured ( P < 0.0001). After correction, the remaining differences between the corrected mechanical and solid-state IVUS measurements similar to differences between repeated measurements with the same IVUS device (i.e., the intraobserver variability). Thus, in serial studies the use of different IVUS devices at index and follow-up procedure may introduce a substantial error as a result of system-related differences. The application of dedicated calibration formulas allows for correction for these differences by decreasing such differences to the level of intraobserver variability.

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“…Intravascular ultrasound provides an accurate assessment of intracoronary plaque volume [1, 2, 58, 59, 70] that is very reproducible [2, 70, 93–95]. The determination of coronary artery cross‐sectional area and plaque volume by IVUS is enhanced by ECG‐gating of the images [2, 70].…”

Section: Reproducibilitymentioning

confidence: 99%