Clinical impact of PCSK9 inhibitor on stabilization and regression of lipid-rich coronary plaques: a near-infrared spectroscopy study

2021 ◽  
Author(s):  
Hideaki Ota ◽  
Hiroyuki Omori ◽  
Masanori Kawasaki ◽  
Akihiro Hirakawa ◽  
Hitoshi Matsuo
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Coronary Plaque ◽  
Lipid Lowering ◽  
Control Group ◽  
Open Label ◽  
Pcsk9 Inhibitor ◽  
Single Centre Study ◽  
Atheroma Volume

Abstract Aims This study aimed to determine the effects of a proprotein convertase subtilisin-kexin type 9 inhibitor (PCSK9i) on coronary plaque volume and lipid components in patients with a history of coronary artery disease (CAD). Methods and results This prospective, open-label, single-centre study analysed non-culprit coronary segments using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) at baseline and follow-up angiography. Following changes in the lipid-lowering treatment based on the most recent guideline, the enrolled subjects were divided into two groups: treatment with PCSK9i and statins (PCSK9i: 21 patients and 40 segments) and statins only (control: 32 patients and 50 segments). The absolute and percent LDL-C reductions were significantly greater in the PCSK9i group than in the control group (between group difference: 59.3 mg/dL and 46.4%; P < 0.001 for both). The percent reduction in normalized atheroma volume and absolute reduction in percent atheroma volume (PAV) were also significantly greater in the PCSK9i group (P < 0.001 for both). Furthermore, the PCSK9i group showed greater regression of maximal lipid core burden index for each of the 4-mm segments (maxLCBI4mm) than the control group (57.0 vs. 25.5; P = 0.010). A significant linear correlation was found between the percent changes in LDL-C and maxLCBI4mm (r = 0.318; P = 0.002), alongside the reduction in PAV (r = 0.386; P < 0.001). Conclusion The lipid component of non-culprit coronary plaques was significantly decreased by PCSK9i. The effects of statin combined with PCSK9i might be attributed to the stabilization and regression of residual vulnerable coronary plaques in patients with CAD.

scholarly journals Near Infrared Spectroscopy Based Clinical Algorithm Applicability During Spinal Neurosurgery and Postoperative Cognitive Disturbances

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 179 ◽  
Author(s):  
Sniedze Murniece ◽  
Martin Soehle ◽  
Indulis Vanags ◽  
Biruta Mamaja
Keyword(s):  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Near Infrared Spectroscopy ◽  
Spinal Surgery ◽  
Near Infrared ◽  
Control Group ◽  
Study Group ◽  
Cerebral Oxygen ◽  
Clinical Algorithm ◽  
Cognitive Disturbances

Background and Objectives: Postoperative cognitive disturbances (POCD) can significantly alter postoperative recovery. Inadequate intraoperative cerebral oxygen supply is one of the inciting causes of POCD. Near-infrared spectroscopy (NIRS) devices monitor cerebral oxygen saturation continuously and can help to guide intraoperative patient management. The aim of the study was to evaluate the applicability of the NIRS-based clinical algorithm during spinal neurosurgery and to find out whether it can influence postoperative cognitive performance. Materials and Methods: Thirty four patients scheduled for spinal neurosurgery were randomized into a study group (n = 23) and a control group (n = 11). We monitored regional cerebral oxygen saturation (rScO2) throughout surgery, using a NIRS device (INVOS 4100). If rScO2 dropped bilaterally or unilaterally by more than 20% from baseline values, or under an absolute value of 50%, the NIRS-based algorithm was initiated in the study group. In the control group, rScO2 was monitored blindly. To evaluate cognitive function, Montreal-Cognitive Assessment (MoCA) scale was used in both groups before and after the surgery. Results: In the study group, rScO2 dropped below the threshold in three patients and the NIRS-based algorithm was activated. Firstly, we verified correct positioning of the head; secondly, we increased mean systemic arterial pressure in the three patients by injecting repeated intravenous bolus doses of Ephedrine, ultimately resulting in an rScO2 increase above the approved threshold level. None of the three patients showed POCD. In the control group, one patient showed a drop in rScO2 of 34% from baseline and presented with a POCD. RScO2 drop occurred with other stable intraoperative measurements. Conclusions: A significant rScO2 drop may occur during spinal surgery in prone position despite other intraoperative measurements remaining stable, allowing it to stay otherwise unrecognized. Use of the NIRS-based clinical algorithm can help to avoid POCD in patients after spinal surgery.

scholarly journals Near-Infrared Spectroscopy Enhances Intravascular Ultrasound Assessment of Vulnerable Coronary Plaque

2015 ◽  
Vol 35 (11) ◽  
pp. 2423-2431 ◽  
Author(s):  
Rishi Puri ◽  
Ryan D. Madder ◽  
Sean P. Madden ◽  
Stephen T. Sum ◽  
Kathy Wolski ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Intravascular Ultrasound ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Coronary Plaque ◽  
Ultrasound Assessment

scholarly journals Stepwise regression of non-culprit lipid-rich plaque observed using serial near-infrared spectroscopy–intravascular ultrasound and optical coherence tomographic measurements after aggressive cholesterol-lowering treatment: a case report

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Norihito Takahashi ◽  
Tomotaka Dohi ◽  
Hirohisa Endo ◽  
Shinya Okazaki
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Optical Coherence ◽  
Stenotic Lesion ◽  
Coronary Syndrome ◽  
Lowering Therapy ◽  
Over Time

Abstract Background Lipid-rich plaques (LRP) in the non-culprit lesions (NCL) in patients with the acute coronary syndrome may trigger lesion-related, adverse cardiovascular events. Aggressive lipid-lowering therapy may stabilize LRP; however, the times of stabilization remain undefined. Case summary A 60-year-old man presented with unstable angina. Coronary angiography revealed a severely stenotic lesion (culprit lesion) in the left descending artery, and another non-obstructive lesion in the distal left main trunk artery. Near-infrared spectroscopy (NIRS) imaging showed LRP with a maximum lipid core burden index (LCBI)4mm of 422. Optical coherence tomographic (OCT) imaging showed the vulnerable plaque as a thin cap fibroatheroma with a thickness of 50 µm. We prescribed aggressive lipid-lowering treatment with a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, and serially observed this lesion for 24 months. The NIRS imaging showed that the LCBI gradually decreased over time (max LCBI4mm of 422, 417, 318, 265, and 106 conducted at index percutaneous coronary intervention, 3, 8, 12, and 24 months, respectively). As plaque regression and stabilization of high-risk LRP were observed, we promptly discontinued treatment with the PCSK9i inhibitor. Discussion During the long-term, 24-month, follow-up using serial NIRS–IVUS imaging, we observed the gradual decrease in LCBI over time, due to aggressive lipid-lowering therapy. Compared with the lowering of low-density lipoprotein cholesterol, the stabilization of vulnerable plaques may require longer times of about 2 years. Evaluation of NCL-related adverse cardiac events by serial intravascular imaging over time, using NIRS–IVUS or OCT, may be warranted in such cases.

Characteristic prefrontal blood volume patterns when imaging body type, high-calorie food, and mother-child attachment in childhood anorexia nervosa: A near infrared spectroscopy study

2011 ◽  
Vol 26 (S2) ◽  
pp. 726-726
Author(s):  
S. Nagamitsu ◽  
M. Matsuoka ◽  
S. Ohzono ◽  
Y. Yamashita ◽  
T. Matsuishi
Keyword(s):  
Anorexia Nervosa ◽  
Infrared Spectroscopy ◽  
Blood Volume ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Control Group ◽  
Body Type ◽  
Child Attachment ◽  
Mother And Child ◽  
High Calorie

IntroductionThe risk for developing and preserving symptoms of anorexia nervosa (AN) in children seems to be multifactorial: individual, familial, socio-cultural, and biological factors interact within the developmental framework. A disruption of attachment processes with the mother in an early stage of child development has been proposed as a contributing factor; however, the evidence is controversial.ObjectivesTo address the research question of how childhood AN patients recognize disorder-specific provocative factors such as body type, high-calorie food, and attachment between mother and child.AimsThe aim of this study was to investigate the prefrontal activation in childhood AN patients when imaging those symptom-provocative factors.MethodsThe prefrontal activations during each task, in terms of blood volume changes, were measured by near infrared spectroscopy. Twelve females with childhood AN (mean age, 14.4 years old) and 13 age-matched healthy female controls participated in this study.ResultsBoth groups showed increased prefrontal blood volume when viewing images of each symptom-provocative factor. Unexpectedly, there was no significant difference in the prefrontal blood volume increases between the control group and the childhood AN group when viewing images of slender and obese body types and high-calorie food. On the other hand, images of mother-child attachment resulted in significantly greater increases in prefrontal blood volume in the childhood AN group than in the control group.ConclusionsThese results indicated that prefrontal activation in AN might be associated with imaging attachment between mother and child, but not associated with imaging body type or high-calorie food.

scholarly journals Motor Cortex Function in Fibromyalgia: A Study by Functional Near-Infrared Spectroscopy

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Eleonora Gentile ◽  
Katia Ricci ◽  
Marianna Delussi ◽  
Filippo Brighina ◽  
Marina de Tommaso
Keyword(s):  
Infrared Spectroscopy ◽  
Motor Cortex ◽  
Near Infrared Spectroscopy ◽  
Resting State ◽  
Near Infrared ◽  
Control Group ◽  
Motor Speed ◽  
Functional Near Infrared Spectroscopy ◽  
Motor Cortex Excitability ◽  
Fast Movement

Previous studies indicated changes of motor cortex excitability in fibromyalgia (FM) patients and the positive results of transcranial stimulation techniques. The present study aimed to explore the metabolism of motor cortex in FM patients, in resting state and during slow and fast finger tapping, using functional Near-Infrared Spectroscopy (fNIRS), an optical method which detects in real time the metabolism changes in the cortical tissue. We studied 24 FM patients and 24 healthy subjects. We found a significant slowness of motor speed in FM patients compared to controls. During resting state and slow movement conditions, the metabolism of the motor areas was similar between groups. The oxyhemoglobin concentrations were significantly lower in patients than in control group during the fast movement task. This abnormality was independent from FM severity and duration. The activation of motor cortex areas is dysfunctional in FM patients, thus supporting the rationale for the therapeutic role of motor cortex modulation in this disabling disorder.

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