Association of Plaque Characterization by Intravascular Ultrasound Virtual Histology and Arterial Remodeling

Fujii, Kenichi; Carlier, Stéphane; Mintz, Gary S.; Wijns, William; Colombo, Antonio; Böse, Dirk; Erbel, Raimund; Costa, José de Ribamar; Kimura, Masashi; Sano, Koichi; Costa, Ricardo; Lui, Joanna; Stone, Gregg W.; Moses, Jeffrey W.; Leon, Martin B.

doi:10.1016/j.amjcard.2005.07.054

Cited by 108 publications

(65 citation statements)

References 25 publications

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“…A recent in vivo IVUS study with radiofrequency-derived image analysis demonstrated that fibrofatty tissue comprised 19.8-26.3% and necrotic tissue 5.9-9.6% of the lesions in cases of severe coronary artery disease. 13 Our results are as high as those from previous reports of coronary segments without severe calcification. Some studies have indicated that coronary arterial calcification is a marker for significant coronary atherosclerosis and that patients with high coronary arterial calcification scores are at an increased risk for coronary events.…”

Section: Discussionsupporting

confidence: 65%

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Assessment of the Histological Characteristics of Coronary Arterial Plaque With Severe Calcification

Kume

Okura

Kawamoto

et al. 2007

Circ J

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Section: Discussionsupporting

confidence: 65%

“…However, the incidence of necrotic core and fibrofatty tissue in this study was as high as in previous reports of the lesions associated with severe coronary artery disease. 13 …”

Section: Study Limitationsmentioning

confidence: 99%

Assessment of the Histological Characteristics of Coronary Arterial Plaque With Severe Calcification

Kume

Okura

Kawamoto

et al. 2007

Circ J

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“…When there were several MLA sites, the one with the largest EEM cross-sectional area (CSA) was chosen for evaluation. 18,20 VH uses IVUS RF data to classify plaque into 4 components: namely, fibrous, fibrofatty, dense calcium, and necrotic core components. These components can be identified within plaque, as previously validated by preliminary in vitro and in vivo studies.…”

Section: Ivus Rf Data Acquisition and Analysismentioning

confidence: 99%

“…17 The remodeling index (RI) was defined as the ratio of the external elastic membrane (EEM) area of the minimum lumen area (MLA) site to the EEM area of the proximal reference site, as previously described. 8,[18][19][20] Two lesions involving the ostium and 9 bifurcation lesions were excluded from the RI evaluation because no proximal reference site could be defined for these lesions.…”

Section: Definitionsmentioning

confidence: 99%

Impact of Culprit Plaque Composition on the No-Reflow Phenomenon in Patients With Acute Coronary Syndrome An Intravascular Ultrasound Radiofrequency Analysis

Higashikuni

Tanabe

Tanimoto

et al. 2008

Circ J

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ercutaneous coronary intervention (PCI) is the most common and effective strategy for treating acute coronary syndrome (ACS), but it is not always successful, mainly because of the no-reflow phenomenon, 1,2 which is associated with poor functional and clinical outcomes, even when Thrombolysis In Myocardial Infarction (TIMI) flow of grade 3 is acquired at the end of the procedure. [2][3][4] To elucidate the mechanisms underlying the no-reflow phenomenon and to predict its occurrence, differences in the culprit plaque morphology in patients with and without the no-reflow phenomenon have been investigated by grayscale intravascular ultrasound (IVUS) studies. Previous studies have demonstrated that a large plaque burden, positive remodeling, and lipid pool-like images increase the risk for the no-reflow phenomenon. [5][6][7][8][9] However, the detailed differences in the plaque composition between patients with and without the no-reflow phenomenon have been difficult to assess with gray-scale IVUS.Recently, spectral analysis of IVUS radiofrequency (RF) data has been shown to provide detailed quantitative and Circulation Journal Vol.72, August 2008 qualitative information on the composition of coronary plaques in vivo. 10-14 A study by Nasu et al found that in vivo characterization of coronary plaques by 'virtual histology' (VH) correlated favorably with the results of in vitro histopathological examination of tissue samples obtained by directional coronary atherectomy. 15 In the present study, we used VH to assess the differences in culprit plaque composition between ACS patients with and without the no-reflow phenomenon. Methods Patients and LesionsBetween June 2005 and April 2006, 103 consecutive individuals were admitted with ACS. They had either acute myocardial infarction within 24 h of onset or unstable angina of Braunwald's class IIIB (angina at rest without increased creatine kinase (CK)-MB activity within 24 h before coronary angiography). For these patients, coronary angiography was performed to identify culprit lesions, and then PCI was carried out. If thrombi were angiographically detected, percutaneous aspiration thrombectomy with TVAC™ (Nipro Corporation, Osaka, Japan) was performed to minimize the influence of thrombi on subsequent IVUS examinations, 16 which were carried out to assess the morphology of the culprit plaques. If a mobile mass with homogenous echo density, suggestive of thrombus, was also found on IVUS examination, percutaneous aspiration thrombectomy was repeated until the mass was not detected on IVUS examination. However, IVUS examination was not attempted Hiroyoshi Nakajima, MD; Kazuhiro Hara, MD Background The difference in the culprit plaque composition of acute coronary syndrome (ACS) patients with and without the no-reflow phenomenon has not been fully evaluated. Methods and ResultsIntravascular ultrasound radiofrequency data of culprit plaques were obtained and analyzed in 49 ACS patients. The no-reflow phenomenon was defined as a decrease of at least 1 grade in 'Thrombolysi...

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“…Positive arterial remodeling (compensatory enlargement) is more often observed in lesions of patients who have acute coronary syndromes (ACS) or vulnerable (rupture-prone) plaques. 2 Expressed in most karyocytes, cystatin C regulates cysteine proteinase activity and counterbalances the degradation of the ECM. By…”

Section: Introductionmentioning

confidence: 99%

Clinical Prognostic Significance of Plasma Cystatin C Levels among Patients With Acute Coronary Syndrome

Ren

Liu

et al. 2009

Clinical Cardiology

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Background: This article aims to investigate the changes of plasma cystatin C concentration (PcyC), and to evaluate the relationship between PcyC and acute coronary syndrome. Methods: A total of 126 consecutive patients with coronary artery disease (CAD) were enrolled in this study, consisting of 34 patients with stable angina pectoris (SAP), 56 patients with unstable angina pectoris (UAP), 36 patients with acute myocardial infarction (AMI), and 34 healthy subjects as controls. Plasma cystatin C, high sensitivity C-reactive protein (hs-CRP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and uric acid (UA) in all subjects were determined. All patients were followed up for 6 months and adverse cardiovascular events were recorded. Results: Plasma cystatin C was elevated in CAD. Cystatin C levels were significantly higher in UAP patients than those in SAP patients and controls (2013.83 ± 633.85 ng/mL vs 1348.41 ± 369.62 ng/mL and 1509.99 ± 408.65 ng/mL, P < 0.05), but were much lower than those in AMI patients (2013.83 ± 633.85 ng/mL vs 2873.55 ± 1149.48 ng/mL, P < 0.05). Patients with AMI also exhibited significantly higher cystatin C levels than SAP patients and the control group (2873.55 ± 1149.48 ng/mL vs 1348.41 ± 369.62 ng/mL and 1509.99 ± 408.65 ng/mL, P < 0.01). Much higher hs-CRP concentrations were found in UAP patients (1.58 ± 2.81 mg/L, P < 0.05) and AMI patients (20.68 ± 18.98 mg/L, P < 0.01). Cystatin C was positively and significantly correlated with age, hs-CRP, white blood cells (WBC), creatinine, and UA (r > 0, P < 0.05), whereas a significantly negative correlation was observed with HDL-C (r = −0.227, P < 0.05). These coefficients were clearly high for creatinine (r = +0.612) and WBC (r = +0.459). During the 6 month followup, 26 patients were found with adverse cardiovascular events and had significantly higher cystatin C levels than the 22 control patients at admission (2356.73 ± 897.64 ng/mL vs 1469.51 ± 574.83 ng/mL, P < 0.01). Conclusions: Cystatin C plays an important role in the development of CAD and PcyC is a strong predictor for risk of cardiovascular events.

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Association of Plaque Characterization by Intravascular Ultrasound Virtual Histology and Arterial Remodeling

Cited by 108 publications

References 25 publications

Assessment of the Histological Characteristics of Coronary Arterial Plaque With Severe Calcification

Assessment of the Histological Characteristics of Coronary Arterial Plaque With Severe Calcification

Impact of Culprit Plaque Composition on the No-Reflow Phenomenon in Patients With Acute Coronary Syndrome An Intravascular Ultrasound Radiofrequency Analysis

Clinical Prognostic Significance of Plasma Cystatin C Levels among Patients With Acute Coronary Syndrome

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