Characterization of Plaque Components With Intravascular Ultrasound Elastography in Human Femoral and Coronary Arteries In Vitro

Korte, Chris L. de; Pasterkamp, Gérard; Steen, Antonius F.W. van der; Woutman, Hein; Bom, N.

doi:10.1161/01.cir.102.6.617

Cited by 353 publications

(192 citation statements)

References 23 publications

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“…The example shown in Fig. 5A illustrates that IMT locally even increases during the cardiac cycle (⌬IMT Ͼ 0), suggesting possible displacement of wall mass from adjacent parts of the arterial wall to the focal site (8,10). Other subjects with positive inhomogeneities showed similar features.…”

Section: Discussionmentioning

confidence: 82%

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Assessment of spatial inhomogeneities in intima media thickness along an arterial segment using its dynamic behavior

Meinders¹,

Kornet²,

Hoeks³

2003

American Journal of Physiology-Heart and Circulatory Physiology

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Hoeks. Assessment of spatial inhomogeneities in intima media thickness along an arterial segment using its dynamic behavior. Am J Physiol Heart Circ Physiol 285: H384-H391, 2003. First published March 13, 2003 10.1152/ajpheart. 00729.2002To assess locally deviating structural and mechanical properties of arterial walls, the spatial variance in end-diastolic intima media thickness (IMT) and the change in IMT during the cardiac cycle (⌬IMT) were determined along a short segment of the common carotid artery (15.86 mm), at 16 positions simultaneously. Intrasubject spatial inhomogeneities along the artery were revealed by a spatial variance significantly larger than the temporal variance over several beats. If differences between positions were confirmed, the extent of the inhomogeneity was obtained by comparison of IMT and ⌬IMT at each position with their spatial medians Ϯ the least-significant difference. Because no intersubject comparisons were necessary, a single session of several measurements was sufficient to assess inhomogeneities in the arterial wall properties of a subject, making the method independent of biological variability between subjects. The method was evaluated on 47 presumed healthy subjects (age range 21-75 yr). In 22 subjects, spatial inhomogeneities in ⌬IMT occurred (P Ͻ 0.05). In young subjects, ⌬IMT was locally decreased, i.e., in systole inhomogeneities were less compressed than their surrounding tissue. In older subjects, ⌬IMT was locally increased, i.e., the inhomogeneity was locally more compressed than its surrounding wall tissue. ultrasound; radial strain; compressibility; arterial stiffness IN THE EARLY DEVELOPMENT of cardiovascular disease (CVD), arteries first become more elastic, whereafter they stiffen (11,20). Assessing these locally changed structural and mechanical properties noninvasively in a single subject is difficult mainly due to the small spatial and temporal changes involved. Even at more advanced stages, changes in arterial wall properties are hard to determine because most methods suffer from low sensitivity and specificity. For instance, even though an increased intima media thickness (IMT) of the common carotid artery (CCA) marks changing vessel wall properties and seems to be a potential candidate to predict the future development of CVD (15, 21), the correlation between increased carotid IMT and CVD is weak. This weak correlation is a result of CVD being a focal phenomenon confined to the intima with a relatively small thickness (Ϸ2.5% of IMT). Only in more diseased arteries does the intima constitute Ͼ20% of the IMT. The correlation between IMT and CVD is further attenuated due to the physiological effects of aging (16). Hence, carotid IMT has to be significantly increased (Ϸ1.2 mm) to be conclusive (1). To enhance sensitivity, IMT is analyzed along an arterial segment and several measurements are averaged (3). However, recent lesions, fatty streaks, more advanced lesions (atheroma), and fully developed complicated plaques tend to be localized at specific sites...

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Section: Discussionmentioning

confidence: 82%

“…Although ⌬IMT is not the same as elasticity, it can be envisaged that it will change when artery wall properties are altered (8,10). Intrasubject comparison of spatial with temporal variance in ⌬IMT showed inhomogeneities in a surprisingly large number of subjects (Fig.…”

Section: Discussionmentioning

confidence: 99%

Assessment of spatial inhomogeneities in intima media thickness along an arterial segment using its dynamic behavior

Meinders¹,

Kornet²,

Hoeks³

2003

American Journal of Physiology-Heart and Circulatory Physiology

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“…Advanced mathematical algorithms including radiofrequency analysis (RFA) and elastography allow a more detailed analysis 96,97 . IVUS-derived RFA (virtual histology, VH-IVUS) displays the reconstructed data as a color coded tissue map of plaque composition based on validation to histology [98][99][100] .…”

Section: Plaque Composition With Ivusmentioning

confidence: 99%

Métodos por imagem da aterosclerose em estudos de progressão/regressão: marcador substituto ou janela direta para o processo patológico da aterosclerose?

Schoenhagen¹,

Tuzcu²

2008

Arq. Bras. Cardiol.

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SummaryCAD remains a major global cause of morbidity and mortality. Comprehensive drug development programs of novel pharmacological treatment strategies frequently utilize traditional mortality/morbidity endpoints studies and additional surrogate endpoints trials. This parallel approach allows an assessment of efficacy several years in advance of the availability of data from clinical endpoint trials. Several atherosclerosis imaging markers have been introduced into these drug-development strategies, including angiography, carotid ultrasound, IVUS, MRI, and CT. This review will discuss the current status of atherosclerosis imaging as an endpoint in progression/regression trials, with an emphasis on evidence-based data. In addition to a discussion of the results of individual imaging modalities, the emerging data comparing different modalities and approaches are presented.

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“…8 Preliminary experiments revealed that it is feasible to discriminate between fatty, fatty fibrous, and fibrous material with this technique. 9 The structure and the composition of the vessel change with age, hypertension, diabetes mellitus, and many other factors. 10 Because composition of the vessel wall affects the mechanical properties of a vessel, the analysis of mechanical behavior of the vessel wall may enhance our understanding of the pathophysiology of atherosclerotic disease.…”

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confidence: 99%

Characterizing Vulnerable Plaque Features With Intravascular Elastography

et al. 2003

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Background-In vivo detection of vulnerable plaques is presently limited by a lack of diagnostic tools. Intravascular ultrasound elastography is a new technique based on intravascular ultrasound and has the potential to differentiate between different plaques phenotypes. However, the predictive value of intravascular elastography to detect vulnerable plaques had not been studied. Methods and Results-Postmortem coronary arteries were investigated with intravascular elastography and subsequently processed for histology. In histology, a vulnerable plaque was defined as a plaque consisting of a thin cap (Ͻ250 m) with moderate to heavy macrophage infiltration and at least 40% of atheroma. In elastography, a vulnerable plaque was defined as a plaque with a high strain region at the surface with adjacent low strain regions. In 24 diseased coronary arteries, we studied 54 cross sections. In histology, 26 vulnerable plaques and 28 nonvulnerable plaques were found. Receiver operator characteristic analysis revealed a maximum predictive power for a strain value threshold of 1.26%. The area under the receiver operator characteristic curve was 0.85. The sensitivity was 88%, and the specificity was 89% to detect vulnerable plaques. Linear regression showed high correlation between the strain in caps and the amount of macrophages (PϽ0.006) and an inverse relation between the amount of smooth muscle cells and strain (PϽ0.0001). Plaques, which are declared vulnerable in elastography, have a thinner cap than nonvulnerable plaques (PϽ0.0001). Conclusions-Intravascular elastography has a high sensitivity and specificity to detect vulnerable plaques in vitro.

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Characterization of Plaque Components With Intravascular Ultrasound Elastography in Human Femoral and Coronary Arteries In Vitro

Abstract: Different strain values are found between fibrous, fibro-fatty, and fatty plaque components, indicating the potential of intravascular elastography to distinguish different plaque morphologies.

Cited by 353 publications

References 23 publications

Assessment of spatial inhomogeneities in intima media thickness along an arterial segment using its dynamic behavior

Assessment of spatial inhomogeneities in intima media thickness along an arterial segment using its dynamic behavior

Métodos por imagem da aterosclerose em estudos de progressão/regressão: marcador substituto ou janela direta para o processo patológico da aterosclerose?

Characterizing Vulnerable Plaque Features With Intravascular Elastography

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