Volumetric Quantitative Analysis of Tissue Characteristics of Coronary Plaques After Statin Therapy Using Three-Dimensional Integrated Backscatter Intravascular Ultrasound

Kawasaki, Masanori; Sano, Keiji; Okubo, Munenori; Yokoyama, Hiroyuki; Ito, Yoko; Murata, Ichijiro; Tsuchiya, Kunihiko; Minatoguchi, Shinya; Zhou, Xiangrong; Fujita, Hiroshi; Fujiwara, Hisayoshi

doi:10.1016/j.jacc.2004.09.081

Cited by 219 publications

(147 citation statements)

References 36 publications

(36 reference statements)

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“…The observed plaque stabilization effect induced by statins might potentially be attributed to pleomorphic effect including a decrease in the lipid content of plaques, a reduction in the inflammatory burden and an improvement in endothelial function; all promoting a more stable phenotype (67)(68)(69)(70)(71). Notwithstanding, most evidence in this regard remains inconclusive or speculative.…”

Section: Effect Of Statins On Cacmentioning

confidence: 99%

Progression of coronary artery calcification at the crossroads: sign of progression or stabilization of coronary atherosclerosis?

Rodríguez-Granillo

Carrascosa

Bruining

2016

Cardiovasc. Diagn. Ther.

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Coronary artery calcification (CAC) has been strongly established as an independent predictor of adverse events, with a significant incremental prognostic value over traditional risk stratification algorithms.CAC progression has been associated with a higher rate of events. In parallel, several randomized studies and meta-analysis have shown the effectiveness of statins to slow progression and even promote plaque regression. However, evidence regarding the effect of routine medical therapy on CAC has yielded conflicting results, with initial studies showing significant CAC regression, and contemporaneous data showing rather the opposite. Accordingly, there is currently a great controversy on whether progression of CAC is a sign of progression or stabilization of coronary artery disease (CAD). The finding of inexorable CAC progression despite the implementation of intensive contemporaneous medical therapy suggests that further understanding of this phenomenon should be undertaken before the implementation of CAC as a surrogate endpoint for longitudinal studies, or for prospective follow-up of patients under routine medical treatment.

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Section: Effect Of Statins On Cacmentioning

confidence: 99%

Progression of coronary artery calcification at the crossroads: sign of progression or stabilization of coronary atherosclerosis?

Rodríguez-Granillo

Carrascosa

Bruining

2016

Cardiovasc. Diagn. Ther.

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“…The Kawasaki group at the Gifu University Graduate School of Medicine in Japan has published studies using integrated backscatter signals from the radiofrequency signal of ultrasound, and based on the backscatter IVUS image, they have used colour to code different components of plaque. 8,9 Another established technique developed by Volcano Corporation® (Rancho Cordova, CA, US) uses radiofrequency signals to determine plaque composition. 10 In this technique, the distortion of radiofrequency signal by the plaque is passed through an algorithm, which is then colour-coded and superimposed on the grey image -a technique commercialised as 'Virtual Histology intravascular ultrasound' (VH-IVUS).…”

Section: Characterisation Of Atherosclerosismentioning

confidence: 99%

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Rathod¹,

Hamshere²,

Jones³

et al. 2015

Interventional Cardiology Review

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Coronary angiography has been the gold standard technique for evaluating coronary arterial disease for the past 50 years. Increasingly, however, realisation of the limitations of coronary angiography, mainly the inability to supply information regarding the coronary wall, has prompted the design and development of adjunctive technologies to better evaluate not just luminal disease but also the burden and character of atherosclerotic plaque within the vessel. The development of intracoronary imaging modalities, namely intravascular ultrasound (IVUS) and optical coherence tomography (OCT), has progressed quickly and these technologies now have established roles in the diagnosis and treatment of coronary artery disease. In general, intracoronary devices that can assess the coronary endothelium use either acoustic or optical signals that are received by a coronary catheter (IVUS uses ultrasound, OCT uses near-infrared light).This review addresses these two widely used intracoronary imaging techniques, looking at their clinical applications, recent evidence for their use and describes new developments in the field. Intravascular UltrasoundIn the last 25 years IVUS has been established as the most commonly used intracoronary imaging device. An IVUS system consists of a flexible monorail catheter with an ultrasound transducer at its tip that emits ultrasound waves in the 10-40 MHz range and an electronics console to reconstruct the image (see Figure 1).1 After reflection from tissue, part of the ultrasound energy returns to the transducer and is converted into the image.There are two types of IVUS transducers for clinical use: the mechanical rotating transducer and the electronically switched phased array system.The mechanical transducer uses a single crystal on a rotational device, which visualises the entire vessel in cross-section providing better image quality (compared with phased array technology) of 100-150 μm.2 The main disadvantage of mechanical transducers is the central drive shaft that decreases flexibility and prevents the concurrent use of a central guidewire.3 However, newer rotational IVUS catheters have developed a monorail system that allows for the presence of a central guidewire.Phased array catheters use multiple transducer elements, which are mounted along the circumference of the catheter tip. Each element sends and receives ultrasounds from a sector and multiple sectors are gathered to produce a cross-sectional image of the artery. However, they are disadvantaged by a technically complex set-up, requiring detailed programming; 3 but some of the newer catheters are easier to set up.Intracoronary imaging of coronary vessels by IVUS is performed using standard coronary interventional techniques and equipment (guiding catheter and 0.014 inch angioplasty guidewire) for catheter delivery along the guidewire beyond the target lesion/area of interest. Intravenous heparin and glyceryl trinitrate (nitroglycerin) are routinely administered before imaging. The IVUS catheter is then drawn back across the tar...

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“…Using virtual histology (VH)-IVUS, the TRUTH study reported that fibrous plaques regressed more in patients in whom statin treatment led to the regression of coronary plaque than in those in whom this increased. 21) Moreover, in an investigation of changes in plaque components using IB-IVUS in patients with stable angina pectoris, Kawasaki, et al 7) reported that the internal administration of atorvastatin (20 mg) could cause plaque lipid components to be replaced by fibrous components. We demonstrated that statin treatment caused reductions in fibrous components, in contrast to findings of previous reports.…”

Section: Discussionmentioning

confidence: 99%

“…5,6) Plaque stability can potentially be achieved by a change in plaque contents, such as the removal of lipids from the lipid-rich plaque and an increase in its fibrous tissue, without an improvement in the degree of plaque volume. 7) Using serial IVUS examinations in patients with stable angina pectoris, the Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin versus Atorvastatin (SATURN) trial revealed that water-soluble and lipid-soluble statins provided comparable benefits in reducing plaque volume. 8) These statins have different chemical structures and show differences in their cell-membrane permeability.…”

mentioning

confidence: 99%

Impact of Water- and Lipid-Soluble Statins on Nonculprit Lesions in Patients with Acute Coronary Syndrome

et al. 2018

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SummaryStatins can be differentiated into two types, based on their solubility, which have potentially differing effects on the coronary artery wall. However, suspected differences in statins' effects on plaque composition have not been systemically investigated.Sixty-seven patients with acute coronary syndrome (ACS) were randomly assigned to either atorvastatin (10 mg/day) or rosuvastatin (2.5 mg/day). Intravascular ultrasound (IVUS) and integrated backscatter (IB)-IVUS, an established tool to quantify each plaque's components, were performed immediately after emergent percutaneous coronary intervention (PCI). Follow-up IVUS was performed between 6 and 12 months after PCI. Serial changes in serum lipid profiles and plaque composition volumes were compared between the two groups.Thirty-five patients were eligible for serial IB-IVUS analyses. The mean low-density lipoprotein-cholesterol level significantly decreased in the atorvastatin and rosuvastatin groups (P < 0.001); plaque volumes were also significantly reduced from 82.0 ± 46.2 to 74.9 ± 41.3 mm 3 (P = 0.01) and from 74.7 ± 35.3 to 67.7 ± 27.0 mm 3 (P = 0.02), respectively. IB-IVUS revealed a significant reduction in fibrous volume from 33.8 ± 20.0 to 27.5 ± 14.9 mm 3 (P < 0.01) and from 29.6 ± 13.6 to 24.8 ± 7.6 mm 3 (P < 0.05), respectively; however, significant changes were not noted in the volume of the lipid pool for the atorvastatin group and the rosuvastatin group, respectively.Water-and lipid-soluble statins may be similarly effective in reducing coronary plaques in patients with ACS as judged qualitatively and quantitatively. Further study is needed to determine whether differences between water-and lipid-soluble statins affect plaque components.(Int Heart J 2018; 59: 27-34)

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Volumetric Quantitative Analysis of Tissue Characteristics of Coronary Plaques After Statin Therapy Using Three-Dimensional Integrated Backscatter Intravascular Ultrasound

Abstract: Statin therapy reduced the lipid component in patients with stable angina without reducing the degree of stenosis. Three-dimensional IB IVUS offers the potential for quantitative volumetric tissue characterization of coronary atherosclerosis.

Cited by 219 publications

References 36 publications

Progression of coronary artery calcification at the crossroads: sign of progression or stabilization of coronary atherosclerosis?

Progression of coronary artery calcification at the crossroads: sign of progression or stabilization of coronary atherosclerosis?

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Impact of Water- and Lipid-Soluble Statins on Nonculprit Lesions in Patients with Acute Coronary Syndrome

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