Near-infrared spectroscopy (NIRS), new intracoronary imaging technique of unstable coronary plaque

Česká verzia

Authors: Tomáš Ondrúš; Jan Kaňovský; Martin Poloczek; Roman Miklík; Otakar Boček; Petr Jeřábek; Petr Kala
Authors place of work: Interní kardiologická klinika LF MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC
Published in the journal: Vnitř Lék 2014; 60(5-6): 531-534
Category: Case Report

Summary

Acute coronary syndrome may develop in the background of hemodynamically non-significant coronary artery disease. It may be caused by the presence of „vulnerable plaque“, which is characterized by the lipid rich core and thin fibrous cap content. NIRS – near infrared spectroscopy – is a morphological imaging method allowing determining atherosclerotic plaque cholesterol burden. Information about the chemical composition may contribute to „high risk” plaque early identification and subsequent optimal interventional strategy. The first experience with the clinical implementation of this novel method is demonstrated in a case report.

Key words:
acute coronary syndrome – chemogram – intravascular imaging – NIRS – vulnerable plaque

Zdroje

1. Go AS, Mozaffarian D, Roger VL et al. Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation 2013; 127(1): e6-e245.

2. Pijls NH, van Schaardenburgh P, Manoharan G et al. Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study. J Am Coll Cardiol 2007; 49(21): 2105–2111.

3. Tonino PAL, De Bruyne B, Pijls NH et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med 2009; 360(3): 213–224.

4. Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation 1995; 92(3): 657–671.

5. Buja LM, Willerson JT. Role of inflammation in coronary plaque disruption. Circulation 1994; 89(1): 503–505.

6. Cassis LA, Lodder RA. Near-IR imaging of atheromas in living arterial tissue. Anal Chem 1993; 65(9): 1247–1256.

7. Moreno PR, Lodder RA, Purushothaman KR et al. Detection of lipid pool, thin fibrous cap, and inflammatory cells in human aortic atherosclerotic plaques by near-infrared spectroscopy. Circulation 2002; 105(8): 923–927.

8. Gardner CM, Tan H, Hull EL et al. Detection of lipid core coronary plaques in autopsy specimens with a novel catheter-based near-infrared spectroscopy system. JACC Cardiovasc Imaging 2008; 1(5): 638–648.

9. Waxman S, Dixon SR, L’Allier P et al. In vivo validation of a catheter-based near-infrared spectroscopy system for detection of lipid core coronary plaques: initial results of the SPECTACL study. JACC Cardiovasc Imaging 2009; 2(7): 858–868.

10. Hong YJ, Mintz GS, Kim SW et al. Impact of plaque composition on cardiac troponin elevation after percutaneous coronary intervention: an ultrasound analysis. JACC Cardiovasc Imaging 2009; 2(4): 458–468.

11. Kolodgie FD, Burke AP, Farb A et al. The thin-cap fibroatheroma: a type of vulnerable plaque: the major precursor lesion to acute coronary syndromes. Curr Opin Cardiol 2001; 16(5): 285–292.

12. Goldstein JA, Grines C, Fischell T et al. Coronary embolization following balloon dilation of lipid-core plaques. JACC Cardiovasc Imaging 2009; 2(12): 1420–1424.

13. Madder RD, Steinberg DH, Anderson RD. Multimodality direct coronary imaging with combined near-infrared spectroscopy and intravascular ultrasound: initial US experience. Catheter Cardiovasc Interv. 2013; 81(3): 551–557.

14. Virmani R, Kolodgie FD, Burke AP et al. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 2000; 20(5): 1262–1275.