Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque: A 3-vessel optical coherence tomography study

Vergallo, Rocco; Ren, Xia; Yonetsu, Taishi; Katô, Kôji; Uemura, Shiro; Yu, Bo; Jia, Haibo; Abtahian, Farhad; Aguirre, Aaron D.; Tian, Jing; Hu, Sining; Soeda, Tsunenari; Lee, Hang; McNulty, Iris; Park, Seung Jung; Jang, Yangsoo; Prasad, Abhiram; Lee, Stephen; Zhang, Shaosong; Porto, Italo; Biasucci, Luigi M.; Crea, Filippo; Jang, Ik Kyung

doi:10.1016/j.ahj.2013.10.011

Cited by 86 publications

(54 citation statements)

References 18 publications

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“…nieregularne brzegi lub wystające krawędzie), dyssekcja lub zaburzony przepływ. W badaniach patomorfologicznych i wewnątrzwieńcowym obrazowaniu stwierdzono jednoczesne występowanie licznych podatnych na pęknięcie blaszek, w większości z cienką, włóknistą czapeczką [309][310][311]. W badaniach angiograficznych potwierdzono te obserwacje.…”

Section: Identyfikacja Zmiany Odpowiedzialnej Za Niedokrwienieunclassified

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi¹,

Patrono²,

Collet³

et al. 2015

Kardiol Pol

210

165

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Section: Identyfikacja Zmiany Odpowiedzialnej Za Niedokrwienieunclassified

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi¹,

Patrono²,

Collet³

et al. 2015

Kardiol Pol

210

165

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“…8,14 We defined lipid-rich plaque as a lesion in which the lipid arc subtended an angle ≥90°. 8,14 Fibrous cap thickness of a lipid plaque was measured 3 times at its thinnest part, and the averaged value was used.14 TCFA was defined as lipid-rich plaque covered by a fibrous cap thinner than 65 μm. 8,14,15 For the assessment of macrophage density, each fibrous cap was automatically segmented using a previously validated algorithm, 16 and the normalized standard deviation (NSD) of the OCT signal was measured on the raw FD-OCT data, as previously described.…”

mentioning

confidence: 99%

“…8,14 Fibrous cap thickness of a lipid plaque was measured 3 times at its thinnest part, and the averaged value was used.…”

mentioning

confidence: 99%

Endothelial Shear Stress and Coronary Plaque Characteristics in Humans

Vergallo

Papafaklis

Yonetsu

et al. 2014

Circ: Cardiovascular Imaging

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Background-Despite the exposure of the entire vasculature to the atherogenic effects of systemic risk factors, atherosclerotic plaques preferentially develop at sites with disturbed flow. This study aimed at exploring in vivo the relationship between local endothelial shear stress (ESS) and coronary plaque characteristics in humans using computational fluid dynamics and frequency-domain optical coherence tomography. Methods and Results-Three-dimensional coronary artery reconstruction was performed in 21 patients (24 arteries) presenting with acute coronary syndrome using frequency-domain optical coherence tomography and coronary angiography. Each coronary artery was divided into sequential 3-mm segments and analyzed for the assessment of local ESS and plaque characteristics. in arterial segments that are straight and have no obstruction, is typically vasculoprotective, whereas high ESS (>≈2.5 Pa), occurring at the throat of an obstruction or at the outer curvature of an artery, may be associated with local erosion and enhanced platelet aggregation. [4][5][6] Recently, the Prediction of Progression of Coronary Artery Disease and Clinical Outcome Using Vascular Profiling of Shear Stress and Wall Morphology (PREDICTION) study showed in vivo the effect of low ESS on plaque progression by means of a systematic vascular profiling, which combined ESS computation with intravascular ultrasound (IVUS)-derived morphometric data.1 Interestingly, virtual histology-IVUS studies suggested an association between low ESS and plaque necrotic core and calcium areas.7 However, because of the lack of imaging modalities with adequate resolution, the in vivo relationship between local ESS and microscopic coronary plaque characteristics has never been investigated in humans.Optical coherence tomography (OCT) is a high-resolution intracoronary imaging modality enabling an accurate in vivo characterization of atherosclerotic plaques.8 OCT is able to detect microstructural features, such as fibrous cap thickness, neovascularization, and macrophage density, and represents the modality of choice for the identification of thin-cap fibroatheroma (TCFA), considered the prototype of the ruptured-prone plaque. The aim of this study was to investigate in vivo the relationship between local ESS and coronary plaque features, using systematic vascular profiling, which combines computational fluid dynamics and frequency-domain (FD)-OCT analysis in humans. Methods Study PopulationPatients with acute coronary syndrome (ACS) who underwent FD-OCT imaging before percutaneous coronary intervention were identified from the Massachusetts General Hospital OCT Registry database. Inclusion criteria were (1) FD-OCT pullback length ≥25 mm between corresponding proximal and distal anatomic landmarks (ie, major branches) to be used for three-dimensional (3D) reconstruction; (2) X-ray coronary angiograms with ≥2 projections with a difference in angle >35°; and (3) no history of previous stent implantation in the artery to be studied. From a total of 117 patients wit...

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“…Известно, что фиб-роатерома с тонкой покрышкой является предшес-твенником разрыва бляшки с последующим тром-бозом [7], что, в свою очередь, является наиболее частой причиной внезапной кардиальной смерти, инфаркта миокарда и ОКС [8]. Фиброатерома с тонкой покрышкой чаще выявлялась у пациентов с нестабильной, чем со стабильной стенокардией [2,9], а при ОКС -в группе с разрывом бляшки, чем без разрыва (52,9% против 19,0%, p=0,029) [10]. Согласно гистологическим исследованиям, неста-бильные бляшки имеют следующие характеристи-ки [11,12]: тонкую фиброзную капсулу (≤ 65 мкм), большое липидное ядро, неоваскуляризицию, ин-фильтрацию фиброзной капсулы активированны-ми макрофагами.…”

Section: окт в диагностике нестабильной бляшкиunclassified

Optical Coherence Tomography Opportunities in Detection of Coronary Plaque Morphology

Mustafina¹,

Загидуллин²,

Ишметов³

et al. 2017

CSO

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Оптическая когерентная томография (ОКТ) является методом внутрисосудистой визуализации коронарных артерий с сверхточной разрешающей способностью, ос-нованным на принципе интерферометрии. В обзоре представлена техническая ха-рактеристика ОКТ-системы, даны основные характеристики ОКТ изображений. Про-анализирован опыт применения ОКТ в диагностике «уязвимой» атеросклеротической бляшки, распознавании морфологии бляшки как причины острого коронарного син-дрома. Данный обзор рассматривает актуальность применения ОКТ в научных иссле-дованиях и клинической практике в области интервенционной кардиологии.Ключевые слова: внутрисосудистая оптическая когерентная томография, атеро-склеротическая бляшка, острый коронарный синдром.

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Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque: A 3-vessel optical coherence tomography study

Cited by 86 publications

References 18 publications

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Endothelial Shear Stress and Coronary Plaque Characteristics in Humans

Optical Coherence Tomography Opportunities in Detection of Coronary Plaque Morphology

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