Christian Zanchin1, Yasushi Ueki1, Sylvain Losdat2, Gregor Fahrni3, Joost Daemen4, Anna S Ondracek5, Jonas D Häner1, Stefan Stortecky1, Tatsuhiko Otsuka1, George C M Siontis1, Fabio Rigamonti6, Maria Radu7, David Spirk8, Christoph Kaiser3, Thomas Engstrom7, Irene Lang5, Konstantinos C Koskinas1, Lorenz Räber1. 1. Cardiology Department, Bern University Hospital, University of Bern, 3012 Bern, Switzerland. 2. Department of Social and Preventive Medicine, Clinical Trials Unit, Institute of Social and Preventive Medicine, Bern University Hospital, 3012 Bern, Switzerland. 3. Department of Cardiology, University Hospital Basel, 4031 Basel, Switzerland. 4. Department of Cardiology, Erasmus Medical Center, 3015 Rotterdam, the Netherlands. 5. Department of Cardiology, Medical University of Vienna, 1090 Vienna, Austria. 6. Department of Cardiology, Geneva University Hospital, 1205 Geneva, Switzerland. 7. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark. 8. Department of Pharmacology, Institute of Pharmacology, University of Bern, 3012 Bern, Switzerland.
Abstract
AIMS: We assessed morphological features of near-infrared spectroscopy (NIRS)-detected lipid-rich plaques (LRPs) by using optical coherence tomography (OCT) and intravascular ultrasound (IVUS). METHODS AND RESULTS: IVUS-NIRS and OCT were performed in the two non-infarct-related arteries (non-IRAs) in patients undergoing percutaneous coronary intervention for treatment of an acute coronary syndrome. A lesion was defined as the 4 mm segment with the maximum amount of lipid core burden index (maxLCBI4mm) of each LRP detected by NIRS. We divided the lesions into three groups based on the maxLCBI4mm value: <250, 250-399, and ≥400. OCT analysis and IVUS analysis were performed blinded for NIRS. We measured fibrous cap thickness (FCT) by using a semi-automated method. A total of 104 patients underwent multimodality imaging of 209 non-IRAs. NIRS detected 299 LRPs. Of those, 41% showed a maxLCBI4mm <250, 39% a maxLCBI4mm 251-399, and 19% a maxLCBI4mm ≥400. LRPs with a maxLCBI4mm ≥400, as compared with LRPs with a maxLCBI4mm 250-399 and <250, were more frequently thin-cap fibroatheroma (TCFA) (42.1% vs. 5.1% and 0.8%; P < 0.001) with a smaller minimum FCT (80 μm vs. 110 μm and 120 μm; P < 0.001); a higher IVUS-derived percent atheroma volume (53% vs. 53% and 44%; P < 0.001) and a higher remodelling index (1.08 vs. 1.02 and 1.01; P < 0.001). MaxLCBI4mm correlated with OCT-derived FCT (r = 0.404; P < 0.001) and was the best predictor for TCFA with an optimal cut-off value of 401 (area under the curve = 0.882; P < 0.001). CONCLUSION: LRPs with increasing maxLCBI4mm exhibit OCT and IVUS features of presumed plaque vulnerability including TCFA morphology, increased plaque burden, and positive remodelling. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: We assessed morphological features of near-infrared spectroscopy (NIRS)-detected lipid-rich plaques (LRPs) by using optical coherence tomography (OCT) and intravascular ultrasound (IVUS). METHODS AND RESULTS: IVUS-NIRS and OCT were performed in the two non-infarct-related arteries (non-IRAs) in patients undergoing percutaneous coronary intervention for treatment of an acute coronary syndrome. A lesion was defined as the 4 mm segment with the maximum amount of lipid core burden index (maxLCBI4mm) of each LRP detected by NIRS. We divided the lesions into three groups based on the maxLCBI4mm value: <250, 250-399, and ≥400. OCT analysis and IVUS analysis were performed blinded for NIRS. We measured fibrous cap thickness (FCT) by using a semi-automated method. A total of 104 patients underwent multimodality imaging of 209 non-IRAs. NIRS detected 299 LRPs. Of those, 41% showed a maxLCBI4mm <250, 39% a maxLCBI4mm 251-399, and 19% a maxLCBI4mm ≥400. LRPs with a maxLCBI4mm ≥400, as compared with LRPs with a maxLCBI4mm 250-399 and <250, were more frequently thin-cap fibroatheroma (TCFA) (42.1% vs. 5.1% and 0.8%; P < 0.001) with a smaller minimum FCT (80 μm vs. 110 μm and 120 μm; P < 0.001); a higher IVUS-derived percent atheroma volume (53% vs. 53% and 44%; P < 0.001) and a higher remodelling index (1.08 vs. 1.02 and 1.01; P < 0.001). MaxLCBI4mm correlated with OCT-derived FCT (r = 0.404; P < 0.001) and was the best predictor for TCFA with an optimal cut-off value of 401 (area under the curve = 0.882; P < 0.001). CONCLUSION: LRPs with increasing maxLCBI4mm exhibit OCT and IVUS features of presumed plaque vulnerability including TCFA morphology, increased plaque burden, and positive remodelling. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Eline M J Hartman; Giuseppe De Nisco; Annette M Kok; Ayla Hoogendoorn; Adriaan Coenen; Frits Mastik; Suze-Anne Korteland; Koen Nieman; Frank J H Gijsen; Anton F W van der Steen; Joost Daemen; Jolanda J Wentzel Journal: J Cardiovasc Transl Res Date: 2020-10-09 Impact factor: 4.132