scholarly journals Influence of Myocardial Bridge On Atherosclerotic Plaque Distribution and Characteristics Evaluated By Near-Infrared Spectroscopy Intravascular Ultrasound

2021 ◽  
Author(s):  
Kan Saito ◽  
Hideki Kitahara ◽  
Takaaki Mastuoka ◽  
Naoto Mori ◽  
Kazuya Tateishi ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Intravascular Ultrasound ◽  
Near Infrared Spectroscopy ◽  
Atherosclerotic Plaque ◽  
Lipid Content ◽  
Near Infrared ◽  
Proximal Segment ◽  
Plaque Burden ◽  
Myocardial Bridge ◽  
Ivus Imaging

Abstract Purpose This study aims to clarify whether myocardial bridge (MB) could influence atherosclerotic plaque characteristics assessed by using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) imaging. Methods One hundred and sixteen patients who underwent percutaneous coronary intervention (PCI) using NIRS-IVUS imaging were included. MB was defined as an echo-lucent band surrounding left anterior descending artery (LAD). In MB patients, LAD was divided into 3 segments: proximal, MB, and distal segments. In non-MB patients, corresponding 3 segments were defined based on the average length of the above segments. Segmental maximum plaque burden and lipid content derived from NIRS-IVUS imaging in the section of maximum plaque burden were evaluated in each segment. Lipid content of atherosclerotic plaque was evaluated as lipid core burden index (LCBI) and maxLCBI4mm. LCBI is the fraction of pixels indicating lipid within a region multiplied by 1000, and the maximum LCBI in any 4-mm region was defined as maxLCBI4mm. Results MB was identified in 42 patients. MB was not associated with maximum plaque burden in proximal segment. LCBI and maxLCBI4mm were significantly lower in patients with MB than those without in proximal segment. Multivariable analysis demonstrated both MB and maximum plaque burden in proximal segment to be independent predictors of LCBI in proximal segment. Conclusion Lipid content of atherosclerotic plaque assessed by NIRS-IVUS imaging was significantly smaller in patients with MB than those without. MB could be considered as a predictor of lipid content of atherosclerotic plaque when assessed by NIRS-IVUS imaging.

Abstract 14949: Influence of Myocardial Bridge on Atherosclerotic Plaque Distribution and Characteristics Evaluated by Near Infrared Spectroscopy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kan Saito ◽  
Hideki Kitahara ◽  
Takaaki Matsuoka ◽  
Naoto Mori ◽  
Kazuya Tateishi ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Atherosclerotic Plaque ◽  
Lipid Content ◽  
Near Infrared ◽  
Multivariable Analysis ◽  
Proximal Segment ◽  
Plaque Burden ◽  
Myocardial Bridge ◽  
Ivus Imaging

Introduction: Myocardial bridge (MB) has been reported to be associated with developed atherosclerosis in the segment proximal to MB. Near-Infrared Spectroscopy (NIRS) identify the lipid content of atherosclerotic plaque as lipid core burden index (LCBI) but little is known about the influence of MB on characteristics of atherosclerosis assessed by NIRS imaging. Methods: 116 consecutive patients who underwent percutaneous coronary intervention using NIRS were included. MB was defined as an echo-lucent band surrounding left anterior descending artery (LAD) which could be detected by gray-scale intravascular ultrasound (IVUS). In MB patients, LAD was divided into 3 segments: proximal segment, MB segment, and distal segment. In non-MB patients, corresponding 3 segments were defined based on the average length of the above segments. Segmental maximum plaque burden and lipid content derived from NIRS-IVUS imaging in the section of maximum plaque burden were evaluated in each segment. Results: MB was identified in 42 patients. MB was not associated with maximum plaque burden in the proximal segment. Whereas MB was negatively correlated with both LCBI and max LCBI 4mm in the proximal segment. Multivariable analysis demonstrated both MB and maximum plaque burden in proximal segment to be independent predictors of LCBI or LCBI 4mm in proximal segment. Conclusions: MB was negatively correlated with both LCBI and max LCBI 4mm in the proximal segment and could be considered as an independent predictor of lipid content of atherosclerotic plaque assessed by NIRS-IVUS imaging.

In vivo relationship between near-infrared spectroscopy-detected lipid-rich plaques and morphological plaque characteristics by optical coherence tomography and intravascular ultrasound: a multimodality intravascular imaging study

2020 ◽  
Author(s):  
Christian Zanchin ◽  
Yasushi Ueki ◽  
Sylvain Losdat ◽  
Gregor Fahrni ◽  
Joost Daemen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Infrared Spectroscopy ◽  
Intravascular Ultrasound ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Multimodality Imaging ◽  
Plaque Burden ◽  
Optical Coherence ◽  
Coronary Syndrome ◽  
Automated Method

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.

scholarly journals Target Lesion Lipid Content Detected by Near-Infrared Spectroscopy After Stenting and the Risk of Subsequent Target Lesion Failure

2021 ◽  
Author(s):  
Ryan D. Madder ◽  
Takashi Kubo ◽  
Yasushi Ino ◽  
Takeyoshi Kameyama ◽  
Kosei Terada ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Intravascular Ultrasound ◽  
Near Infrared Spectroscopy ◽  
Lipid Content ◽  
Near Infrared ◽  
Target Lesion ◽  
Ultrasound Images ◽  
Characteristic Analysis ◽  
Target Lesion Failure

Objective: After percutaneous coronary intervention (PCI), it is unknown whether retained lipid content in the stented segment increases the risk of target lesion failure (TLF). This study evaluated the association between retained lipid content in the stented segment detected by post-PCI intracoronary near-infrared spectroscopy and TLF. Approach and Results: After the performance of PCI, post-PCI near-infrared spectroscopy–intravascular ultrasound images were acquired and analyzed by an independent core laboratory for retained lipid content in the stented segment, quantified by the maximum lipid core burden index in 4 mm (maxLCBI 4mm ). The primary outcome was TLF during follow-up, defined as a composite of cardiovascular death, target vessel myocardial infarction, and clinically driven target lesion revascularization. Among 202 patients with 209 target lesions treated by PCI and followed for 3.5±1.4 years, baseline post-PCI near-infrared spectroscopy–intravascular ultrasound images revealed a significantly greater maxLCBI 4mm in stented lesions with (297 [211, 401]) versus without (119 [9, 258]) TLF during follow-up ( P =0.006). By multivariate logistic regression, maxLCBI 4mm in the stented segment was independently associated with subsequent TLF (odds ratio, 1.6 [95% CI, 1.2–2.1] for every 100-unit increase, P =0.004). By receiver-operating characteristic analysis, the optimal residual maxLCBI 4mm threshold in the stented segment for subsequent TLF was 200. Stented lesions with a residual maxLCBI 4mm >200 had significantly greater TLF during follow-up than stented lesions with a maxLCBI 4mm ≤200 (15.0% versus 3.1%, P =0.002). Conclusions: Retained lipid content detected by near-infrared spectroscopy in the stented segment after PCI was associated with an increased risk of subsequent TLF.

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