Intracoronary Thermography

Abstract

Arteriosclerosis is an inflammatory disease. Inflammatory processes play a role in the initiation of plaque development and the early stages of the disease as well as in complex plaques and complications such as intraarterial thrombosis. A method to detect inflammation in coronary arteries has the potential to characterize both local and systemic activation of arteriosclerotic plaque disease. It could help to define in more detail what constitutes a vulnerable plaque or vulnerable vessel and thus improve the prediction of acute coronary syndromes. Intracoronary thermography records a cardinal sign of inflammation. Heat is probably produced by (activated) macrophages. Experimental work has suggested that thermal heterogeneity is present in arteriosclerotic plaques and that increased temperature is found at the site of inflammatory cellular-macrophage-infiltration. Preliminary experience in patients undergoing coronary angiography has demonstrated that it is safe and feasible to perform intracoronary thermography using various systems. A graded relationship between thermal heterogeneity and clinical symptoms has been reported, with the greatest temperature elevation in acute myocardial infarction. Increases in thermal heterogeneity appeared to be associated with a comparably unfavorable long-term prognosis. Intracoronary thermography has the potential to provide insights into location and extent of inflammation as well as the prognostic consequences. Currently, this novel method and the underlying concepts are extensively evaluated.

Intracoronary thermography: Utility to detect vulnerable and culprit plaques in patients with coronary artery disease

“…More recently, several other groups have reported similar fi ndings, albeit lower degrees of thermal heterogeneity in plaques of CAD patients [18][19][20]. These differences may be attributable to the different types of thermistors used to measure plaque temperature and differences in the patient populations studied, including the use of statin medications, which have been shown to reduce thermal heterogeneity [21][22][23].…”

Characterization of Atherosclerotic Plaques by Laser Speckle Imaging

“…12,22,24,[27][28][29][30][31][32][33][34] These methods are complementary to techniques that measure biomechanical properties because they provide structural and compositional information that contributes to plaque stability. Intravascular ultrasound elastography facilitates atherosclerotic plaque characterization by computing local strains in the plaque in response to intraluminal pressure differentials exerted on the arterial wall.…”

Intravascular Thermography for Assessing Vulnerable Plaques

“…Another study showed increased plaque temperature for an extended period after myocardial infarction, indicating that the inflammatory process is sustained after plaque rupture [22]. To further investigate the role of inflammation in arterial heat production, Schmermund et al [23] used a non-occluding thermography catheter (Volcano Therapeutics, Rancho Cordova, CA). Focal temperature heterogeneity was observed in 50% of patients with acute coronary syndrome (ACS) and 27% of patients with SA [23].…”

“…To further investigate the role of inflammation in arterial heat production, Schmermund et al [23] used a non-occluding thermography catheter (Volcano Therapeutics, Rancho Cordova, CA). Focal temperature heterogeneity was observed in 50% of patients with acute coronary syndrome (ACS) and 27% of patients with SA [23]. Wainstein et al [24] used a different thermography catheter (ThermoCoil Guidewire), and patients were also evaluated by intravascular ultrasound.…”