scholarly journals Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris　― Evaluation With Histopathology and Optical Coherence Tomography ―

2019 ◽  
Vol 83 (12) ◽  
pp. 2452-2459 ◽  
Author(s):  
Hiroshi Okamoto ◽  
Teruyoshi Kume ◽  
Ryotaro Yamada ◽  
Terumasa Koyama ◽  
Tomoko Tamada ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Angina Pectoris ◽  
Clinical Significance ◽  
Stable Angina ◽  
Optical Coherence ◽  
Stable Angina Pectoris

Abstract 3324: Assessment of Coronary Calcification by Optical Coherence Tomography in the Culprit Lesions: Comparison between Acute Coronary Syndrome and Stable Angina Pectoris

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Masato Mizukoshi ◽  
Takashi Kubo ◽  
Shigeho Takarada ◽  
Hironori Kitabata ◽  
Takashi Tanimoto ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Angina Pectoris ◽  
Stable Angina ◽  
Optical Coherence ◽  
Luminal Surface ◽  
Culprit Lesion ◽  
Stable Angina Pectoris ◽  
Calcium Deposit ◽  
Spotty Calcification ◽  
Calcium Deposits

[BACKGROUND] Calcification is an important phenomenon of atherosclerosis. Histopathological and intravascular ultrasound studies suggest that the characteristics of calcification might be associated with the pathogenesis of the vulnerable plaque. Optical coherence tomography (OCT) is a high-resolution imaging modality and allows us to analyse the plaque morphology in detail. In this study, we assessed the characteristics of calcification by OCT at the sites of culprit lesions in acute myocardial infarction (AMI), unstable angina pectoris (UAP), and stable angina pectoris (SAP). [METHOD and RESULTS] We evaluated the characteristics of calcification in the 20-mm-long culprit lesion segment per patient by OCT in 56 patients (AMI : n=21, UAP : n=14, SAP : n=21). In each patient, the number of calcium deposits, the arc, the distance from the luminal surface to each calcification were measured. Each calcium deposit was categorized into one of two groups by the arc : spotty calcification : a small calcium deposit with an arc of less than 90 degrees ; large calcification : a calcific lesion with an arc of more than 90 degrees. The average number of spotty calcification per patient in AMI and UAP was significantly greater than that in SAP (AMI 1.7+/−1.3, UAP 1.9+/−1.7, and SAP 0.6+/−0.8, p=0.012; AMI vs SAP, p=0.046, UAP vs SAP, p=0.030). The average number of large calcification per patient in AMI was significantly lower than that in SAP (AMI0.2+/−0.4, UAP 0.42+/−0.7, and SAP0.9+/−0.7; AMI vs SAP, p=0.005). Consequently, the percent of spotty calcification in each culprit lesion was higher in AMI and UAP than in SAP (AMI 87.5%, UAP 81.3%, and SAP40.1%, p<0.01). The distance between the luminal surface and the inner edge of each spotty calcification was significantly shorter in AMI and UAP than in SAP (AMI 0.18+/−0.11mm, UAP 0.15+/−0.1mm, SAP 0.30+/−0.13mm, p<0.001; AMI vs SAP, p=0.007, and UAP vs SAP, p=0.001), but that of each large calcification was not significantly different among AMI, UAP, and SAP. [CONCLUSION] In the culprit lesions of AMI and UAP, calcium deposits more spotty in size and more close to the lumen would be observed frequently. These characteristics of the calcium deposition might play an important role in the pathogenesis of the plaque vulnerability.

scholarly journals Feasibility and Clinical Significance of In Vivo Cholesterol Crystal Detection Using Optical Coherence Tomography

2020 ◽  
Vol 40 (1) ◽  
pp. 220-229 ◽  
Author(s):  
Yosuke Katayama ◽  
Atsushi Tanaka ◽  
Akira Taruya ◽  
Manabu Kashiwagi ◽  
Tsuyoshi Nishiguchi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Angina Pectoris ◽  
Stable Angina ◽  
High Specificity ◽  
Multivariable Logistic Regression Analysis ◽  
Optical Coherence ◽  
Stable Angina Pectoris ◽  
Fibrous Cap ◽  
Superficial Type

Objective: Cholesterol crystals (CCs) are frequently found at the site of acute myocardial infarctions (AMIs), but the role of CCs in the onset of AMI remains unclear due to the lack of validated in vivo imaging tools. The aim of this study was to validate the ability of optical coherence tomography (OCT) to detect CCs and to compare the prevalence and distribution of CCs in patients with AMIs and stable angina pectoris. Approach and Results: CC assessment using OCT were compared with histopathology results in 45 coronary samples. We investigated 152 consecutive patients with AMIs and 41 patients with single vessel-diseased stable angina pectoris. Based on the presence of plaque ruptures (PR), AMI patients were divided into 2 groups: those with PR (n=112) and those without PR (n=40). CCs invading fibrous caps were defined as superficial-type CCs. A multivariable logistic regression analysis was performed to determine PR predictors. The sensitivity and specificity of OCT for detecting CCs were 68% and 92%, respectively. The prevalence of plaques with CCs was higher in the AMI with PR group (AMI with PR 81%, AMI without PR 48%, stable angina pectoris 39%, P <0.01). A multivariable logistic model showed that superficial-type CCs and thin-cap fibroatheromas were positive predictors for PR. Conclusions: OCT has a high specificity and modest sensitivity for the detection of CCs. The combination of CCs invading fibrous cap and thin-cap fibroatheromas detected by OCT may better identify rupture-prone plaques.

Abstract 12944: Patients With Acute Coronary Syndrome, Compared to Those With Stable Angina Pectoris, Have Increased Bright Spots at the Culprit Site by Optical Coherence Tomography

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yoshiyasu Minami ◽  
Jennifer E Phipps ◽  
Taylor Hoyt ◽  
Marc D Feldman ◽  
Ik-Kyung Jang
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Stable Angina ◽  
Coronary Risk Factors ◽  
Optical Coherence ◽  
Culprit Lesion ◽  
Stable Angina Pectoris ◽  
Coronary Syndrome ◽  
Bright Spots

Background: Recent studies reported that bright spots detected by optical coherence tomography (OCT) represent more complex plaques including macrophages and cholesterol crystals. We hypothesized that the density and area of bright spots would be greater at the culprit lesion in patients with acute coronary syndrome (ACS) compared to those with stable angina pectoris (SAP). Aim: To compare the density and extent of bright spots in the culprit lesion between patients with ACS and with SAP. Methods: We identified 14 ACS and 17 SAP patients who underwent pre-PCI OCT imaging of the culprit lesion. Cases with poor image quality or left main disease were excluded. Bright spots within superficial 125μm of the vessel wall were identified in a 5mm length segment at the culprit site. The density was calculated as the number of bright pixels identified by the algorithm divided by the number of pixels in each frame (total 25 frames in one case). The area of bright spots was also calculated. Results: There were no significant differences in the baseline characteristics including mean age (65.9 ± 10.2 vs 65.2 ± 9.32 yrs, P=0.83) and the prevalence of coronary risk factors between ACS and SAP. Mean and maximum density of bright spots was significantly greater in ACS than in SAP (Table). The area of bright spots was also significantly larger in ACS. Among ACS patients, a subgroup with plaque rupture (n=11) had much greater mean density and area compared with SAP (1.20 [0.41-1.73] vs 0.44 [0.21-0.58], P=0.01, 5.32 [1.88-8.07] vs 2.06 [0.97-2.64], P=0.01). Conclusions: Using the novel algorithm, we demonstrate that the density and area of bright spots are significantly greater in ACS than in SAP. This result suggests that the measurement of bright spots can be useful to determine plaque vulnerability.

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