Morphological and mechanical information of coronary arteries obtained with intravascular elastography; feasibility study in vivo.

AIMS Plaque composition is a major determinant of coronary related clinical syndromes. In vitro experiments on human coronary and femoral arteries have demonstrated that different plaque types were detectable with intravascular ultrasound elastography. The aim of this study was to investigate the feasibility of applying intravascular elastography during interventional catheterization procedures. METHODS AND RESULTS Data were acquired in patients (n=12) during PTCA procedures with an EndoSonics InVision echoapparatus equipped with radiofrequency output. The systemic pressure was used to strain the tissue, and the strain was determined using cross-correlation analysis of sequential frames. A likelihood function was determined to obtain the frames with minimal motion of the catheter in the lumen, since motion of the catheter prevents reliable strain estimation. Minimal motion was observed near end-diastole. Reproducible strain estimates were obtained within one pressure cycle and over several pressure cycles. Validation of the results was limited to the information provided by the echogram. Strain in calcified material (0.20%+/-0.07) was lower (P<0.001) than in non-calcified tissue (0.51%+/-0.20). CONCLUSION In vivo intravascular elastography is feasible. Significantly higher strain values were found in non-calcified plaques than in calcified plaques.

[1]  R. Virmani,et al.  Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. , 1997, The New England journal of medicine.

[2]  Marvin M. Doyley,et al.  Advancing intravascular palpography towards clinical application , 2002 .

[3]  R D Kamm,et al.  Effects of fibrous cap thickness on peak circumferential stress in model atherosclerotic vessels. , 1992, Circulation research.

[4]  J. Ophir,et al.  Elastography: A Quantitative Method for Imaging the Elasticity of Biological Tissues , 1991, Ultrasonic imaging.

[5]  Samin K. Sharma,et al.  Noninvasive in vivo human coronary artery lumen and wall imaging using black-blood magnetic resonance imaging. , 2000, Circulation.

[6]  A F van der Steen,et al.  Intravascular ultrasound combined with Raman spectroscopy to localize and quantify cholesterol and calcium salts in atherosclerotic coronary arteries. , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[7]  G. Puppels,et al.  Raman spectroscopy for quantifying cholesterol in intact coronary artery wall. , 1998, Atherosclerosis.

[8]  F J Schoen,et al.  Computational structural analysis based on intravascular ultrasound imaging before in vitro angioplasty: prediction of plaque fracture locations. , 1993, Journal of the American College of Cardiology.

[9]  A. Fischman,et al.  Imaging Human Atherosclerosis with 99mTc‐labeled Low Density Lipoproteins , 1988, Arteriosclerosis.

[10]  E. Topol,et al.  Our preoccupation with coronary luminology. The dissociation between clinical and angiographic findings in ischemic heart disease. , 1995, Circulation.

[11]  Antonio Colombo,et al.  Clinical application and image interpretation in intracoronary ultrasound , 1998 .

[12]  V. Fuster,et al.  Radiotracers for low density lipoprotein biodistribution studies in vivo: technetium-99m low density lipoprotein versus radioiodinated low density lipoprotein preparations. , 1988, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[13]  J. Hodgson,et al.  Intracoronary ultrasound imaging: correlation of plaque morphology with angiography, clinical syndrome and procedural results in patients undergoing coronary angioplasty. , 1993, Journal of the American College of Cardiology.

[14]  C L de Korte,et al.  Echo decorrelation from displacement gradients in elasticity and velocity estimation , 1999, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[15]  P. Fitzgerald,et al.  Detection of intralesional calcium by intracoronary ultrasound depends on the histologic pattern. , 1994, American Heart Journal.

[16]  S. L. Bridal,et al.  Correlation of ultrasonic attenuation (30 to 50 MHz and constituents of atherosclerotic plaque. , 1997, Ultrasound in medicine & biology.

[17]  M S Feld,et al.  Determination of human coronary artery composition by Raman spectroscopy. , 1997, Circulation.

[18]  B. S. Gow,et al.  The Elasticity of Canine and Human Coronary Arteries with Reference to Postmortem Changes , 1979, Circulation research.

[19]  F Prati,et al.  Correlation between high frequency intravascular ultrasound and histomorphology in human coronary arteries , 2001, Heart.

[20]  J. G. Fujimoto,et al.  Assessing atherosclerotic plaque morphology: comparison of optical coherence tomography and high frequency intravascular ultrasound. , 1997, Heart.

[21]  B Lundberg,et al.  Chemical composition and physical state of lipid deposits in atherosclerosis. , 1985, Atherosclerosis.

[22]  W. Vaughn,et al.  Comparison of angioscopy, intravascular ultrasound imaging and quantitative coronary angiography in predicting clinical outcome after coronary intervention in high risk patients. , 1996, Journal of the American College of Cardiology.

[23]  S. Emelianov,et al.  Strain Imaging of Coronary Arteries with Intraluminal Ultrasound: Experiments on an Inhomogeneous Phantom , 1996 .

[24]  P Toutouzas,et al.  Thermal heterogeneity within human atherosclerotic coronary arteries detected in vivo: A new method of detection by application of a special thermography catheter. , 1999, Circulation.

[25]  V. Bhargava,et al.  Axial movement of the intravascular ultrasound probe during the cardiac cycle: implications for three-dimensional reconstruction and measurements of coronary dimensions. , 1999, American heart journal.

[26]  Colin R. Janssen,et al.  Angle matching in intravascular elastography. , 2000, Ultrasonics.

[27]  E. Falk,et al.  Coronary thrombosis: pathogenesis and clinical manifestations. , 1991, The American journal of cardiology.

[28]  D.N. Stephens,et al.  Blood speed imaging with an intraluminal array , 2000, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[29]  F. Foster,et al.  Ultrasonic Measurement of Differential Displacement and Strain in a Vascular Model , 1997, Ultrasonic imaging.

[30]  M. Fishbein,et al.  How big are coronary atherosclerotic plaques that rupture? , 1996, Circulation.

[31]  W. Roberts,et al.  Morphologic comparison of frequency and types of acute lesions in the major epicardial coronary arteries in unstable angina pectoris, sudden coronary death and acute myocardial infarction. , 1991, Journal of the American College of Cardiology.

[32]  N Bom,et al.  Characterization of plaque components with intravascular ultrasound elastography in human femoral and coronary arteries in vitro. , 2000, Circulation.

[33]  V. Fuster,et al.  The pathogenesis of coronary artery disease and the acute coronary syndromes (2). , 1992, The New England journal of medicine.

[34]  C T Lancée,et al.  Intravascular elasticity imaging using ultrasound: feasibility studies in phantoms. , 1997, Ultrasound in medicine & biology.

[35]  G. V. R. Born,et al.  INFLUENCE OF PLAQUE CONFIGURATION AND STRESS DISTRIBUTION ON FISSURING OF CORONARY ATHEROSCLEROTIC PLAQUES , 1989, The Lancet.

[36]  T. Stijnen,et al.  Comparison of intravascular ultrasonic findings after coronary balloon angioplasty evaluated in vitro with histology. , 1995, The American journal of cardiology.

[37]  A J Tajik,et al.  Intravascular ultrasound imaging: in vitro validation and pathologic correlation. , 1990, Journal of the American College of Cardiology.

[38]  C T Lancée,et al.  Simulation of circular array ultrasound transducers for intravascular applications. , 2000, The Journal of the Acoustical Society of America.

[39]  Bridget Wilcken,et al.  Pathogenesis of coronary artery disease , 1969 .

[40]  V. Fuster,et al.  13C-NMR spectroscopy of human atherosclerotic lesions. Relation between fatty acid saturation, cholesteryl ester content, and luminal obstruction. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[41]  Anton F. W. van der Steen,et al.  Vascular plaque characterization using intravascular ultrasound elastography and NIR Raman spectroscopy in vitro , 2000, Medical Imaging.

[42]  M. Davies,et al.  Atherosclerotic plaque caps are locally weakened when macrophages density is increased. , 1991, Atherosclerosis.

[43]  M. Matsuzaki,et al.  Detection of Fibrous Cap in Atherosclerotic Plaque by Intravascular Ultrasound by Use of Color Mapping of Angle-Dependent Echo-Intensity Variation , 2001, Circulation.

[44]  W. Roberts,et al.  Coronary artery imaging with intravascular high-frequency ultrasound. , 1990, Circulation.

[45]  R. Kamm,et al.  Distribution of Circumferential Stress in Ruptured and Stable Atherosclerotic Lesions A Structural Analysis With Histopathological Correlation , 1993, Circulation.

[46]  P. Libby,et al.  The unstable atheroma. , 1997, Arteriosclerosis, thrombosis, and vascular biology.

[47]  H. Weisman,et al.  Imaging of Vascular Injury With 99mTc‐Labeled Monoclonal Antiplatelet Antibody S12: Preliminary Experience in Human Percutaneous Transluminal Angioplasty , 1992, Circulation.

[48]  M J Davies,et al.  Stability and instability: two faces of coronary atherosclerosis. The Paul Dudley White Lecture 1995. , 1996, Circulation.

[49]  Roger D. Kamm,et al.  The Impact of Calcification on the Biomechanical Stability of Atherosclerotic Plaques , 2001, Circulation.

[50]  G. Bearman,et al.  Thermal detection of cellular infiltrates in living atherosclerotic plaques: possible implications for plaque rupture and thrombosis , 1996, The Lancet.

[51]  René M. Botnar,et al.  Noninvasive Coronary Vessel Wall and Plaque Imaging With Magnetic Resonance Imaging , 2000, Circulation.

[52]  J. Ophir,et al.  Elastography: Elasticity Imaging Using Ultrasound with Application to Muscle and Breast in Vivo , 1993, Ultrasonic imaging.

[53]  V. Fuster,et al.  Coronary plaque disruption. , 1995, Circulation.