Volumetric intravascular ultrasound quantification of the amount of atherosclerosis in nonstenotic arterial segments

18A

ABSTRACTS

cling (lesion

- ACCIS2002

(Angiography

EEM CSA more than 5% greater

and negative

remodeling

ence segment)

(lesion

(HOMA)

than at the proximal

reference

segment)

EEM CSA more than 5% less than at the distal refer.

also were evaluated.

model assessment

& Interventional

Insulin resistance

and defined

was determined

by homeostasis

as values above the 75th percentile

with stable angina.

univariate

Clinical

and IVUS variables

analysis were entered into the multivariate

smoking,

JACC

aspirin

intake,

Adrienne,

for ACS

Stable angina

Univariate

p value

Multivariate

p value

Dist. of Columbia,

n=72

6 (46%)

13 (16%)

0.03

0.1

Hypertension

6 (46%)

54 (75%)

0.04

0.01

19 (26%)

o.OQO4

0.002

Long-term

Insulin resistance

10 (77%)

Positive remodeling, However,

absent of hypertension

predictors

for ACS.

multivariate

resistance

was the most powerful

logistic

and insulin resistance

regression

analysis

lar ultrasound

were the

showed

insulin

predictor.

burden

stenoses.

Methods:

pre-interventional

Nineteen

Tomomitsu

Tani, Syoji Yamakami.

Okamoto,

Masaki Ogata. Masahiro

Kazuki Iwata, Yoshimasa

Junji Toyama, Aichi Prefscfuraf

Ichinomiya,

ments of the external

To use intravascular

ble atherosclerotic features

ultrasound

Murakami,

and plaque&media

(EEM minus

planimetry; plaque

positively

and Results:

myocardial

stenoses

remodeled

the plaque contained p=O.l5).

lumen)

79 unstable

acute coronary

(EEM CSA amean

plaque burden is contained

angina),

culprit

lesion

were most frequently LAD, 117 lesions

to evaluate

observed

(65.4%).

at proximal

under

coronary

stenosis (%DS<25%)

in proximal

Vulnerable

plaque

may be more likely to develop

lesions,

features

at proximal

associated

in the proximal

The morphologlcal

Area

RCA (n=26)

61.3tlO.l%

LAD (n=35)

52.1+14.5%

LCx (n=l7)

33.ltl4.6%

1054-17

Kallikazaros,

sites with

Athanasios

interventions

to mid or

sites in the RCA and LAD.

with calcification

atherosclerosis

to heat production

our study was to investigate sclerotic plaques

20/26(76.9%)

6/26(30.6%)

27/35(77.1%)

29/35(65.7%)

9/35(25.7%)

5!17(29.4%)

6/17(35.3%)

O/17(0%)

Toutouzas,

Echolucent

the study we included

Eleftherios

Area

Plaque&media,mm3 Length,mm

Hippokration

Hospital, Athens.

lesions. Administration

the temperature

loon angioplasty

was on physician’s

and underwent

decision.

the catheterization

and low-density

a thermography

used, in order to measure

the temperature

plaque and the healthy vessel wall. Rerulb:

(Medispes difference

population

Methods:

In

angina (UA) and 26 pts with

diagnostic

catheterization.

Bal-

for a period of

pts were also under aspirin

were measured

in all pts. During

S.W.A.G.zug-Switzerland) (TD) between

was

the atherosclerotic

TD was higher in pts with UA compared

to

the study

into pts treated with statins and pts not treated with statins, TD was greater in group

(0.44 * 0.26 vs 0.25 t 0.23 “C. p < 0.01). Moreover,

within each clinical syndrome

had lower TD compared

to untreated

treated

pts

pts (Un: 0.29 2 0.25

vs. 0.45 f 0.26 “C, p < 0.02 and SA: 0.23 f 0.16 vs. 0.42 t 0.24 “C, p < 0.03). Multivariate analysis showed that treatment ment

of temperature

variation,

with statins was an independent

adjusted

Houston,

factor in the assess-

for age, hypercholesterolemia,

hypertension,

Madjid, Ward Casscells, University

that localization

of vulnerable

plaque can be enhanced

of perlorming

fiber optic side-viewing

the correlation.

and placed immediately

Optical

catheter connected

shown

reflectance

spectra

to a spectrometer.

niques were used for the correlation. from the optical NIR calibration

10 human

in a humidified,

penetration

catheter,

carotid

which have

Mat inflamed

regions

our spectroscopy

probe sizes were used to study variable miniaturized

and

by physiological

(T), NO, hypoxia, and oxyradicals.

we chose pH to calibrate

Different

m

of Texas-Houston,

Texas.

plaque are lower in pH. Therefore.

depth.

Eventu-

we demonstrated

endalterectomized

37°C controlled

of

catheter. the

plaques

T glove-box

type

(400 - 1100 nm) were taken with the prototype Partial Least Squares Results:

multivariate

calibration

The R2 of the determination

was 0.63 and the Root Mean Squared

tech-

of tissue pH

Deviation

(RMSD)

was 0.14 pH units.

to-noise leads

process of athero-

plaques.

pts with SA (0.41 * 0.26 vs. 0.32 I 0.1 “C. p < 0.04). When we categorized the untreated

Mohammad

Plaque Research.

We have previously

spectroscopy

effect. The aim of

Statins were administered

cholesterol

catheter


been shown to shift NIR spectra.

Conclusion:

Pitsavos.

of statins may further sta-

of atherosclerotic

(16 pts with UA and 12 pts with SA). Forty-eight

Total cholesterol

231+140 33.4*13.5

Center for Vulnerable

were collected

over a month to 32 pts (16 pts with UA and 14 pts with SA). Thirty pts were not under statin treatment

90*66 9.4i7.6

Tania Khan, Babs Soiler, Peter Melling,

feasibility

Greece.

anti-inflammatory

(pts), 36 pts with unstable

stable angina (SA) who were hospitalized

321*196 42.6t17.7

Progress With the Calibration of a 3F Near infrared Spectroscopy Fiber Optic Catheter for Monitoring the PH of Atherosclerotic Plaque: Introducing a Novel Approach for Detection of Active Vulnerable Plaque

Methods:

Tsiamis, loannis

the effect of statins on the inflammatory

62 patients

(Lesion vs. Reference)
ally, using a unique

Kostas Tsioufis, Christos

due to an additional

by measuring

p-value

Segment

c0.0001

factors such as low pH, high temperature

ex viva and in viva studies have shown, that inflammation

plaques,

Non-Stenotic

459i263

We hypothesized

In proximal

15/26(57.7%)

from atherosclerotic

bilize atherosclerotic

Lesion

226+156

plaques Previous

(r&1.35,

segments.

29+30

Texas Heart Institute,

LCx.

Calcification

Trikas, Pavlos Toutouzas,

length

3l4 of the atherosclerotic

119~111

N&wi,

and echolucence.

Plaque Eccentricity

Sophia Vaina, Manolis Vavouranakis.

Background:

segment

focal stenosis,

257+165

of occult atherosclerosis

RCA and LAD than in the proximal

of occult

Konstantinos

with nonstenotic

of

with lesion length

576~345

1054-19

proximal

Treatment With Statins Results in Decreased Heat Production From the Cuiprlt Atherosclerotic Lesions in Patients With Stable and Unstable Angina

mStefanadis,

inversely

Lumen,mmB

incubator.

treatment.

in the non-stenotic

correlated

to interme-

The percentage

and

sitesof coronaryarteries %Plaque

were compared

from when

arteries were shown below (table).

tends to develop

occult atherosclerotic

features

reference)

EEM.mmJ

at mid-site

of which occult atheroscleroses

during 76 elective coronary

sites in the three major coronary

Conclusion:

the

(41.5%)

obsewed

into VPs in these sites, we also used IVUS to examine

no angiographic

Significant

distribution,

sites in the RCA, 39 lesions

distal target lesions in each vessel. The morphological

with single,

ranging

There was no difference

cases (226 acute

of VP. In the RCA and LAD, VPs

site. To assess evidence

but directly

Total

of vulnera-

into VP.

In the LCx. VPs were more frequently

(20, 59.9%) than at proximal might develop

the distribution

segments,

using

more ath-

IVUS Measurements

was found to be RCA 94, LAD 179, and LCx 34. We then assessed

of these lesions

were obtained Significantly

(EEM CSA
Measure-

area (CSA). lumen CSA,

Results:

in the nonstenotfc

the morphological

syndrome

in the right coronary artery and

CSA, and arcs of calcium

stenoses

In arteries

We used intravascu-

in patients with de nova focal

from crux to ostia were studied.

were calculated.

in the nonstenotic

Conclusions:

of most severe lesions may

outcomes.

(EEM) cross sectional

and volumes

Centsr,

the distribution

arteries and clarii

in these sites that may develop

In 307 consecutive

infarction,

angiography,

wronary

imaging

(p
remodeled

diately/negatively

Mitsuhiro

New York, New

on the extent and severity of athero-

46% to 66% (mean = 72+12%.) of the total plaque volume.

Muto, Takumi Yamada.

Canlovascular

(IVUS) to examine

plaque (VP) in human

of occult atherosclerosis

Methods

C&van’ Hospital

depends

adverse coronary

elastic membrane

Aichi, Japsn.

Objective:

location

Kajiguchi,

anti-inffam-

Hospital Center,

Foundation,

patients with focal stenoses IVUS

(r=O.52, p=O.O234), and weakly, Masahiro

Washington

Research

rather than the number

relation to potentially

complete

computerized

Distribution of Vulnerable Plaque in the Human Coronary Artery: Anglographic and intravascular Ultrasound Analysis of Dccuit Atherosclerosis In Proximal Sites in the Three Major Coronary Arteries

BMatsushita.

with statins

leading to plaque stabilization.

(IVUS) to quantity the overall plaque burden

erosclerotic

1054-16

Cardiovascular

patient outcome

sclerosis. The overall plaque have a stronger

Conclusion:

pts treated

York. Background:

n=13

Positive remodeling

No. of segments

plaque,

Gary S. Mintz, Neil J. Weissman,

Washington, ACS

Conclualons:

lesion. This may be an additional

Volumetric intravascular Uitrasound Quantification of the Amount of Atherosclerosis in Nonstenotic Arterial Segment5

1054-18

with a p value less than 0.1 in

models.

Predlctoe

syndrome.

from the culprii

matory effect of statins on the atherosclerotic

Results: The data was as follows. The Slgnltlcant

and clinical

have less heat production

March 6,2002

(i.e. 1.71).

Patients were divided into two groups: group 1: n=13, patients with ACS; group 2: n=62, patients

Cardiology)

This feasibility

study suggests

that plaque

pH can be determined

in both ex viva and in viva plaque tissues. Further improvements

ratio will be required

to meet the long-term

based on pH. Oue new multi-probe

goal of detection

catheter allows multiple

spectra of the vessel wall. This enabels pH spectrographic

imaging

with NIR in signal-

of vulnerable

radial reading of NIR of vulnerable

plaque.