Potential of optical coherence tomography and intravascular ultrasound in the detection of vulnerable plaques in coronary arteries

Кочергин, Н. А.; Кочергина, А. М.

doi:10.15829/1728-8800-2022-2909

Cardiovasc Ther Prev

2022

DOI: 10.15829/1728-8800-2022-2909

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Potential of optical coherence tomography and intravascular ultrasound in the detection of vulnerable plaques in coronary arteries

Н. А. Кочергин¹,

А. М. Кочергина²

Abstract: Intravascular imaging of vulnerable plaques in vivo has great potential for predicting coronary events. Currently, there are several methods of intravascular imaging, which make it possible to verify the components of the plaque and, accordingly, its vulnerability. The most common are virtual-histology intravascular ultrasound and optical coherence tomography. Several studies have shown that these imaging techniques can stratify the risk of adverse cardiovascular events, as well as assess the effectiveness of … Show more

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Cited by 6 publications

References 34 publications

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Capabilities of intravascular imaging techniques in the diagnosis of cardiac allograft vasculopathy: Literature review

Kolesnikov,

Arnt,

Kochergin

2023

RJTAO

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Cardiac allograft vasculopathy (CAV) is a coronary heart disease (CHD), arising after an orthotopic heart transplant (OHT), and it is one of the leading causes of death in heart recipients. The probability of death is 10%. CAV can manifest as early as 1 year after OHT. Patients do not have pain syndrome that is typical for CHD due to cardiac denervation. The first clinical manifestations may be congestive heart failure, ventricular arrhythmias or even sudden cardiac death. Coronary angiography is the routine technique for CAV detection. However, it is not sensitive enough (about 44%) for CAV detection at an early stage of the disease. Today, intravascular imaging methods (intravascular ultrasound, optical coherence tomography), which allow the evaluation of the morphology of coronary artery lesions, including CAV, have become widespread. This article is devoted to the modern capabilities of intravascular imaging methods in the diagnosis of CAV. CAV is the main cause of myocardial infarction and chronic heart failure in patients after OHT. Intravascular imaging techniques allow early detection of this condition and prevention of unfavorable outcomes in a complex category of heart recipients. Given the advantages of optical coherence tomography (OCT) and disadvantages of intravascular ultrasound (IVUS), OCT appears to be a more informative method of CAV detection.

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Capabilities of intravascular imaging techniques in the diagnosis of cardiac allograft vasculopathy: Literature review

Kolesnikov,

Arnt,

Kochergin

2023

RJTAO

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Atherosclerotic plaque structure according to optical coherence tomography in patients with coronary artery disease living in extreme weather conditions

Utegenov,

Sapozhnikov,

Bessonov

2024

Russ J Cardiol

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Aim. To evaluate the plaque structural features in patients with coronary artery disease (CAD) permanently residing in the Far North of the Tyumen region in comparison with patients in the South of the Tyumen region.Material and methods. This pilot case-control study included 32 patients with stable CAD (mean age 62,7±8,9 years, 24 (75%) men). The main group consisted of 16 patients permanently residing in the Far North of Tyumen region (non-indigenous population), while the comparison group consisted of 16 patients permanently residing in the South of the Tyumen region. In all patients, CAD was verified using paraclinical diagnostic methods. All patients underwent optical coherence tomography (OCT), according to which the plaque type was analyzed. The following plaque types were distinguished: fibrous, fibroatheroma, calcified fibroatheroma, thin-cap fibroatheroma (TCFA). TCFA was defined as the presence of a fibrous cap ≤65 μm thick and an arc of the necrotic core of at least 90о. In addition, a lipid-rich plaque was isolated, which was determined by a lipid arc of more than 180о.Results. According to clinical and angiographic characteristics, patients in the compared groups were statistically comparable. A total of 134 plaques were analyzed from 32 patients (main group — 65 plaques; control group — 69 plaques (p>0,05)). The most common plaque type in both groups was calcified fibroatheroma (46,2% in the Far North group and 50,7% in the South group, p=0,609). TCFA was significantly more often detected in patients living in far north (33,8% vs 17,4%, p=0,031). In this group of patients, thin (<65 µm) fibrous plaque cap was also more often determined (35,4% vs 18,8%, p=0,034). Lipid-rich plaques in both groups was determined with the same frequency (56,9% vs 62,3%, p=0,598).Conclusion. In patients with verified CAD living in extreme weather conditions, according to OCT, TCFA was more often determined, which could potentially be associated with a higher risk of adverse cardiovascular events.

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Potential of diagnostic electron microscopy of calcification, pathological neovascularization and elastolysis in combination with phenotyping of cell populations in large arteries

Mukhamadiyarov,

Klyshnikov,

Koshelev

et al. 2024

Russ J Cardiol

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Aim. To determine the potential of diagnostic electron microscopy of intraplaque processes (severity of lipid damage, fibrous cap thickness and condition, severity of pathological neovascularization, presence, nature and severity of calcification, ratio and distribution of various cell populations).Material and methods. The study objects were plaques removed during endarterectomy from the human carotid artery and segments of the human internal mammary artery removed during coronary bypass surgery. Whole specimens were subjected to chemical fixation, staining with heavy metal salts, embedding in epoxy resin followed by layer-by-layer grinding, polishing, contrasting, visualization using back-scattered electron scanning electron microscopy and three-dimensional reconstruction with color mapping (modified EM-BSEM).Results. The use of a modified EM-BSEM made it possible to: 1) visualize the fibrous cap thickness and assess the extracellular matrix; 2) analyze the neointimal lipid distribution; 3) perform three-dimensional reconstruction and analyze the microenvironment of calcifications of various sizes; 4) visualize endothelial cells, defects in interendothelial contacts and the basement membrane of neointimal capillaries with their subsequent three-dimensional reconstruction; 5) perform an analysis of age-dependent defects in the basement membrane and internal elastic membrane of the internal mammary artery. The resolution of the obtained images was significantly superior to intravascular imaging methods (intravascular ultrasound and optical coherence tomography), allowing additional assessment of capillary fluidity, the degree of calcification encapsulation and the condition of elastic fibers. Three-dimensional reconstruction of calcifications, neointimal capillaries and elastic fibers made it possible to assess their spatial density and heterogeneity. Simultaneously with the identification and assessment of these histological structures, objective phenotyping of cell populations was performed, which made it possible to isolate macrophages and foam cells, vascular smooth muscle cells, fibroblasts and endothelial cells in atherosclerotic plaques and automatically identify them through color mapping determined by their electronic contrast distribution signatures.Conclusion. The modified EM-BSEM method allows for universal electron microscopic diagnosis of atherosclerotic and elastolytic lesions of large arteries with high information content about vascular remodeling and high accuracy. Electronic contrast distribution signatures unique for each cell population indicate the possibility of their automated phenotyping using specialized neural network algorithms.

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Potential of optical coherence tomography and intravascular ultrasound in the detection of vulnerable plaques in coronary arteries

Cited by 6 publications

References 34 publications

Capabilities of intravascular imaging techniques in the diagnosis of cardiac allograft vasculopathy: Literature review

Capabilities of intravascular imaging techniques in the diagnosis of cardiac allograft vasculopathy: Literature review

Atherosclerotic plaque structure according to optical coherence tomography in patients with coronary artery disease living in extreme weather conditions

Potential of diagnostic electron microscopy of calcification, pathological neovascularization and elastolysis in combination with phenotyping of cell populations in large arteries

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