Serial intravascular ultrasound assessment of changes in coronary atherosclerotic plaque dimensions and composition: an update

Abstract

This manuscript reviews the use of serial intravascular ultrasound (IVUS) examination of coronary atherosclerosis in recent observational studies and randomized trials that revealed the effects of cholesterol-lowering and lipid-modifying therapies and offered novel insight into plaque progression and regression. We discuss the value of plaque progression-regression as complementary imaging endpoint and potential surrogate marker of cardiovascular event risk. In addition, the progress in serial assessment of coronary plaque composition and plaque vulnerability by radiofrequency-based analyses is reviewed. Finally, we report on the evaluation of true vessel remodelling in recent serial IVUS trials and discuss the future perspective of serial invasive imaging of coronary atherosclerosis.

Multicenter Analysis of Immune Biomarkers and Heart Transplant Outcomes: Results of the Clinical Trials in Organ Transplantation-05 Study

“…In addition, the IVUS-defined endpoint in CTOT-05 was a measured increase in maximal intimal thickness of >0.5 mm in a matched coronary segment over 1 year. In the ensuing years since the initiation of CTOT-05 the heart transplant research community has adopted volumetric analyses as more sensitive and reliable measures of CAV than measurements of intimal thickness (66). Combined with other documented limitations of IVUS (67) and known coefficients of variance of most biomarkers of ~30% (50, 68), our findings suggest that future multicenter studies of biomarkers in heart transplantation may need to include several hundred evaluable subjects studied with volumetric-based IVUS analyses to have sufficient power to identify meaningful relationships with CAV.…”

Characterization of coronary atherosclerosis by intravascular imaging modalities

“…PCI with the guidance of grayscale IVUS has been demonstrated to reduce incidence of restenosis, stent thrombosis and cardiovascular events after PCI compared to angiographic guidance (14)(15)(16)(17). Recently, IVUS has been increasingly used as the gold standard to evaluate natural history of coronary atherosclerosis under medical therapies (3,5,(18)(19)(20).…”

Update on the efficacy of statin treatment in acute coronary syndromes

“…Conversely, computed tomography (CT) angiography may partially recognize the plaque vulnerability, identifying several structural features of atherosclerotic lesion such as lipid-rich, fibrous or calcified plaque, relying on density measurements [47]. Moreover, intravascular ultrasound (IVUS) is also emerging as pivotal tool in vascular wall assessment, especially in monitoring subclinical progression of coronary atherosclerotic disease [48,49]. On the other hand, IVUS is able to recognize coronary plaque regression induced by statin treatment, as first reported by the Demonstration of the Beneficial Effect on Atherosclerotic Lesions by Serial Volumetric Intravascular Ultrasound Analysis During Half a Year After Coronary Event (ESTABLISH) trial.…”