Tobias Erlöv1, Magnus Cinthio2, Andreas Edsfeldt3, Simon Segstedt2, Nuno Dias4, Jan Nilsson3, Isabel Gonçalves5. 1. Department of Biomedical Engineering, Faculty of Engineering, Lund University, Sweden. Electronic address: tobias.erlov@bme.lth.se. 2. Department of Biomedical Engineering, Faculty of Engineering, Lund University, Sweden. 3. Experimental Cardiovascular Research Group, Department of Clinical Sciences Malmö, Lund University, Sweden. 4. Vascular Center, Skåne University Hospital, Sweden. 5. Experimental Cardiovascular Research Group, Department of Clinical Sciences Malmö, Lund University, Sweden; Department of Cardiology, Skåne University Hospital, Sweden.
Abstract
BACKGROUND: The leading cause of morbidity and mortality worldwide is atherosclerotic cardiovascular disease, most commonly caused by rupture of a high-risk plaque and subsequent thrombosis resulting in stroke, myocardial infarction or sudden death depending on the affected arterial territory. Accurate, non-invasive methods to identify such lesions known as vulnerable or high-risk plaques are currently sub-optimal. Our aim was to validate a new non-invasive ultrasound method to identify high-risk carotid plaques. METHODS: We evaluated a new method based on the center frequency shift (CFS) of the ultrasound radio frequency data obtained from carotid plaques compared to a reference phantom. We evaluated the method both ex vivo, on 157 sections from 18 plaques, and in vivo, in 39 patients 1-day prior to carotid plaque removal, and correlated the data with histology. RESULTS: The CFS correlated with a plaque vulnerability index based on histological areas stained for lipids, macrophages, hemorrhage, smooth muscle cells and collagen (r = -0.726, P = 1.7 × 10(-8)). Plaques with CFS below median had larger cores, more macrophages and were less rich in collagen in agreement with the definition of rupture-prone plaques. The accuracy to detect plaques with high vulnerability index was 78% (confidence interval (CI) 61-89%), with sensitivity 77% (CI 61-89%) and specificity 78% (CI 62-89%). CONCLUSIONS: Our method is the first to characterize atherosclerotic plaque components that affect plaque vulnerability using CFS.
BACKGROUND: The leading cause of morbidity and mortality worldwide is atherosclerotic cardiovascular disease, most commonly caused by rupture of a high-risk plaque and subsequent thrombosis resulting in stroke, myocardial infarction or sudden death depending on the affected arterial territory. Accurate, non-invasive methods to identify such lesions known as vulnerable or high-risk plaques are currently sub-optimal. Our aim was to validate a new non-invasive ultrasound method to identify high-risk carotid plaques. METHODS: We evaluated a new method based on the center frequency shift (CFS) of the ultrasound radio frequency data obtained from carotid plaques compared to a reference phantom. We evaluated the method both ex vivo, on 157 sections from 18 plaques, and in vivo, in 39 patients 1-day prior to carotid plaque removal, and correlated the data with histology. RESULTS: The CFS correlated with a plaque vulnerability index based on histological areas stained for lipids, macrophages, hemorrhage, smooth muscle cells and collagen (r = -0.726, P = 1.7 × 10(-8)). Plaques with CFS below median had larger cores, more macrophages and were less rich in collagen in agreement with the definition of rupture-prone plaques. The accuracy to detect plaques with high vulnerability index was 78% (confidence interval (CI) 61-89%), with sensitivity 77% (CI 61-89%) and specificity 78% (CI 62-89%). CONCLUSIONS: Our method is the first to characterize atherosclerotic plaque components that affect plaque vulnerability using CFS.
Authors: Andreas Edsfeldt; Maarten Swart; Pratibha Singh; Lea Dib; Jiangming Sun; Jennifer E Cole; Inhye Park; Dania Al-Sharify; Ana Persson; Mihaela Nitulescu; Patricia Das Neves Borges; Christina Kassiteridi; Michael E Goddard; Regent Lee; Petr Volkov; Marju Orho-Melander; Lars Maegdefessel; Jan Nilsson; Irina Udalova; Isabel Goncalves; Claudia Monaco Journal: Eur Heart J Date: 2022-05-14 Impact factor: 35.855
Authors: Eva Bengtsson; Karin Hultman; Pontus Dunér; Giuseppe Asciutto; Peter Almgren; Marju Orho-Melander; Olle Melander; Jan Nilsson; Anna Hultgårdh-Nilsson; Isabel Gonçalves Journal: Sci Rep Date: 2017-06-16 Impact factor: 4.379