title: Virtual histology and remodelling index allow in vivo identification of allegedly high-risk coronary plaques in patients with acute coronary syndromes: a three vessel intravascular ultrasound radiofrequency data analysis.
abstract: BACKGROUND
  Virtual histology (VH) uses intravascular ultrasound (IVUS) radiofrequency spectral analysis to locally identify the morphology and composition of atherosclerotic plaques. We sought to explore in vivo the relation between IVUS-derived thin cap fibro-atheroma (IDTCFA) and remodelling index in patients with acute coronary syndromes using IVUS-VH.
  
  
  RESULTS
  Twenty-one patients (63 vessels) were enrolled. When compared to cross sectional areas (CSAs) without necrotic core in contact with the lumen (NCCL), CSAs with NCCL had a larger plaque burden 42.8+/-11.5% vs. 32.8+/-11.5%, p<0.001; higher overall necrotic core content [13.8+/-10.7% vs. 2.3+/-7.9% (p<0.001)] and calcified tissue [4.7+/-6.5 vs. 0.66+/-2.1% (p<0.001)]. On average there were 2 IVUS-derived thin cap fibro-atheroma (IDTCFA) per patient. Nearly half of the IDTCFAs had positive remodelling.
  
  
  CONCLUSIONS
  CSAs with NCCL had worse morphological profiles than those with no NCCL. The simultaneous and more detailed assessment of IDTCFA and remodelling index identifies a reduced number of allegedly high-risk plaques. The findings of this study may have important clinical implications, since they shed light into a possible method of identiying potentially high-risk plaques suitable for pharmacological and/or local treatment.
authors.affiliation: Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Héctor M
authors.initials: HM
authors.lastname: García-García
authors.forename: Dick
authors.initials: D
authors.lastname: Goedhart
authors.forename: Johan C H
authors.initials: JC
authors.lastname: Schuurbiers
authors.forename: Neville
authors.initials: N
authors.lastname: Kukreja
authors.forename: Shuzou
authors.initials: S
authors.lastname: Tanimoto
authors.forename: Joost
authors.initials: J
authors.lastname: Daemen
authors.forename: Marie-Angele M
authors.initials: MA
authors.lastname: Morel
authors.forename: Marco
authors.initials: M
authors.lastname: Bressers
authors.forename: Gerrit-Ann
authors.initials: GA
authors.lastname: van Es
authors.forename: Jolanda J
authors.initials: JJ
authors.lastname: Wentzel
authors.forename: Frank
authors.initials: F
authors.lastname: Gijsen
authors.forename: Antonius F W
authors.initials: AF
authors.lastname: van der Steen
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys