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.
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.
García-García
Héctor M
HM
Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
Goedhart
Dick
D
Schuurbiers
Johan C H
JC
Kukreja
Neville
N
Tanimoto
Shuzou
S
Daemen
Joost
J
Morel
Marie-Angele M
MA
Bressers
Marco
M
van Es
Gerrit-Ann
GA
Wentzel
Jolanda J
JJ
Gijsen
Frank
F
van der Steen
Antonius F W
AF
Serruys
Patrick W
PW