Skip to main content
SpringerLink
Log in

Intravascular ultrasound radiofrequency analysis of the lesion segment profile in ACS patients

  • Original Paper
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Abstract

Background

Intravascular ultrasound radiofrequency analysis (IVUS-RF) characterizes plaque components as necrotic core (NC) and dense calcium (DC). The aim of this study was to perform an IVUS-RF derived analysis of the lesion segment profile in acute coronary syndrome (ACS) patients. Therefore, we compared the site of the minimum lumen area—cross sectional area (mla-CSA) with the worst lesion site—CSA (ws-CSA) defined by the maximum NC site.

Methods

We performed IVUS-RF derived plaque composition and plaque-type classification analysis in 48 ACS patients with 48 culprit (CL) and 69 non-culprit lesions (NCL).

Results

The plaque dimension of the mla- and ws-CSA was significantly different regarding the lumen area (5.18 ± 2.09 mm2 vs. 6.72 ± 2.73 mm2, p = 0.0013) and the vessel area (14.80 ± 5.86 mm2 vs. 17.15 ± 4.94 mm2, p = 0.0142). The absolute plaque composition was also significantly different regarding the DC tissue (0.71 ± 0.57 mm2 vs. 0.98 ± 0.54 mm2, p = 0.0102) and the NC tissue (1.41 ± 1.28 mm2 vs. 1.85 ± 1.37 mm2, p = 0.0469). The plaque-type classification revealed significantly more thin cap fibroatheroma (TCFA) lesions at the ws-CSA compared to the mla-CSA (n = 53/89.8% vs. n = 26/44.1%, p < 0.0001). In the majority of the CL and NCL lesion segments the ws-CSA was located proximal to the mla-CSA compared to the distal location (n = 65/55.6% vs. n = 23/19.7%).

Conclusions

In the majority of the lesion segments in ACS patients the ws-CSA is not identical with the mla-CSA. The ws-CSA compared to mla-CSA presented with significantly more NC and DC tissue resulting in a higher amount of TCFA lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Yusuf S, Reddy S, Ounpuu S, Anand S (2001) Global burden of cardiovascular diseases. Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 104:2855–2864

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  3. Virmani R, Burke AP, Farb A, Kolodgie FD (2006) Pathology of the vulnerable plaque. J Am Coll Cardiol 47:C13–C18

    Article  PubMed  CAS  Google Scholar 

  4. Ambrose JA, Tannenbaum MA, Alexopoulos D, Hjemdahl-Monsen CE, Leavy J, Weiss M, Borrico S, Gorlin R, Fuster V (1988) Angiographic progression of coronary artery disease and the development of myocardial infarction. J Am Coll Cardiol 12:56–62

    Article  PubMed  CAS  Google Scholar 

  5. Little WC, Constantinescu M, Applegate RJ, Kutcher MA, Burrows MT, Kahl FR, Santamore WP (1988) Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild to moderate coronary artery disease? Circulation 78:1157–1166

    PubMed  CAS  Google Scholar 

  6. Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM (2000) Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 20:1262–1275

    PubMed  CAS  Google Scholar 

  7. Burke AP, Farb A, Malcom GT, Liang YH, Smialek J, Virmani R (1997) Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. N Engl J Med 336:1276–1282

    Article  PubMed  CAS  Google Scholar 

  8. Yamagishi M, Terashima M, Awano K, Kijima M, Nakatani S, Daikoku S, Ito K, Yasamura Y, Miyatake K (2000) Morphology of vulnerable coronary plaque: insights from follow-up of patients examined by intravascular ultrasound before an acute coronary syndrome. J Am Coll Cardiol 35:106–111

    Article  PubMed  CAS  Google Scholar 

  9. Schönhagen P, Ziada KM, Kapadia SR, Crowe TD, Nissen SE, Tuzcu EM (2000) Extent and direction of arterial remodeling in stable versus unstable coronary syndromes. An intravascular ultrasound study. Circulation 101:598–603

    Google Scholar 

  10. Rodriguez-Granillo GA, Serruys PW, Garcia-Garcia HM, Aoki J, Valgimigli M, van Mieghem CA, McFadden E, de Jaegere PP, de Feyter P (2006) Coronary artery remodelling is related to plaque composition. Heart 92:388–391

    Article  PubMed  CAS  Google Scholar 

  11. Rodriguez-Granillo GA, Garcia-Garcia HM, Valgimigli M, Vaina S, van Mieghem C, van Geuns RJ, van der Ent M, Regar E, de Jaegere P, van der Giessen W, de Feyter P, Serruys PW (2006) Global characterization of coronary plaque rupture phenotype using three-vessel intravascular ultrasound radiofrequency data analysis. Eur Heart J 27:1921–1927

    Article  PubMed  Google Scholar 

  12. Fujii K, Mintz G, Carlier SG, Costa JR, Kimura M, Sano K, Tanaka K, Costa RA, Lui J, Stone GW, Moses JW, Leon MB (2006) Intravascular ultrasound profile analysis of ruptured coronary plaques. Am J Cardiol 98:429–435

    Article  PubMed  Google Scholar 

  13. Nair A, Kuban BD, Tuzcu EM, Schoenhagen P, Nissen SE, Vince DG (2002) Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation 106:2200–2206

    Article  PubMed  Google Scholar 

  14. König A, Oepke M, Leibig M, Klauss V (2007) Coronary plaque classification using intravascular ultrasound-radiofrequency analysis in a patient with severe coronary vasospasm. Clin Res Cardiol 96:514–518

    Article  PubMed  Google Scholar 

  15. Nasu K, Tsuchikane E, Katoh O, Vince DG, Virmani R, Surmely JF, Murata A, Takeda Y, Ito T, Ehara M, Matsubara T, Terashima M, Suzuki T (2006) Accuracy of in vivo coronary plaque morphology assessment: a validation study of in vivo virtual histology compared with in vitro histopathology. J Am Coll Cardiol 47:2405–2412

    Article  PubMed  Google Scholar 

  16. Rodriguez-Granillo G, Mc Fadden EP, Valgimigli M, van Mieghem CA, Regar E, de Feyter PJ, Serruys PW (2006) Coronary plaque composition of nonculprit lesions, assessed by in vivo intracoronary ultrasound radio frequency data analysis, is related to clinical presentation. Am Heart J 151:1020–1024

    Article  PubMed  Google Scholar 

  17. Surmely JF, Nasu K, Fujita H, Terashima M, Matsubara T, Tsuchikane E, Ehara M, Kinoshita Y, Zheng QX, Tanaka N, Katoh O, Suzuki T (2006) Coronary plaque composition of culprit/target lesions according to the clinical presentation: a virtual histology intravascular ultrasound analysis. Eur Heart J 27:2939–2944

    Article  PubMed  Google Scholar 

  18. Hong MK, Mintz GS, Lee CW, Suh J, Kim JH, Park DW, Lee SW, Kim YH, Cheong SS, Kim JJ, Park SW, Park SJ (2007) Comparison of virtual histology to intravascular ultrasound of culprit coronary lesions in acute coronary syndrome and target coronary lesions in stable angina pectoris. Am J Cardiol 100:953–959

    Article  PubMed  Google Scholar 

  19. Surmely JF, Nasu K, Fujita H, Terashima M, Matsubara T, Tsuchikane E, Ehara M, Kinoshita Y, Takeda Y, Tanaka N, Katoh O, Suzuki T (2007) Association of coronary plaque composition and arterial remodelling: a virtual histology analysis by intravascular ultrasound. Heart 93:928–932

    Article  PubMed  Google Scholar 

  20. Moore MP, Spencer T, Salter DM, Kearney PP, Shaw TR, Starkey ER, Fitzgerald PJ, Erbel R, Lange A, McDicken NW, Sutherland GR, Fox KA (1998) Characterisation of coronary atherosclerotic morphology by spectral analysis of radiofrequency signal. In vitro intravascular ultrasound study with histological and radiological validation. Heart 79:459–467

    PubMed  CAS  Google Scholar 

  21. Nair A, Margolis MP, Kuban BD, Vince DG (2007) Automated coronary plaque characterisation with intravascular ultrasound backscatter: ex vivo validation. EuroIntervention 3:113–120

    PubMed  Google Scholar 

  22. Mintz GS, Nissen SE, Anderson WD, Bailey SR, Erbel R, Fitzgerald PJ, Pinto FJ, Rosenfield K, Siegel RJ, Tuzcu M, Yock PG (2001) American College of Cardiology clinical expert consensus document on standards for acquistion, measurement and reporting of intravascular ultrasound studies (IVUS): a report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 37:1478–1492

    Article  PubMed  CAS  Google Scholar 

  23. König A, Margolis MP, Virmani R, Holmes DR, Klauss V (2008) In vivo coronary plaque classification by intravascular ultrasound derived radiofrequency analysis. Nat Clin Pract Cardiovasc Med 5:219–229

    Article  PubMed  Google Scholar 

  24. Carlier SG, Mintz GS, Stone GW (2006) Imaging of atherosclerotic plaque using radiofrequency ultrasound signal processing. J Nucl Cardiol 13:831–840

    Article  PubMed  Google Scholar 

  25. Rioufol G, Finet G, Ginon I, André-Fouët X, Rossi R, Vialle E, Desjoyaux E, Convert G, Huret JF, Tabib A (2002) Multiple atherosclerotic plaque rupture in acute coronary syndrome: a three-vessel intravascular ultrasound study. Circulation 106:804–808

    Article  PubMed  CAS  Google Scholar 

  26. Hong MK, Mintz GS, Lee CW, Kim YH, Lee SW, Song JM, Han KH, Kang DH, Song JK, Kim JJ, Park SW, Park SJ (2004) Comparison of coronary plaque rupture between stable angina and acute myocardial infarction: a three-vessel intravascular ultrasound study in 235 patients. Circulation 110:928–933

    Article  PubMed  Google Scholar 

  27. Wang JC, Normand SL, Mauri L, Kuntz RE (2004) Coronary artery spatial distribution of acute myocardial infarction occlusions. Circulation 110:278–284

    Article  PubMed  Google Scholar 

  28. Hong MK, Mintz GS, Lee CW, Lee BK, Yang TH, Kim YH, Song JM, Han KH, Kang DH, Cheong SS, Song JK, Kim JJ, Park SW, Park SJ (2005) The site of plaque rupture in native coronary arteries: a three-vessel intravascular ultrasound analysis. J Am Coll Cardiol 46:261–265

    Article  PubMed  Google Scholar 

  29. Cheruvu PK, Finn AV, Gardner C, Caplan J, Goldstein J, Stone GW, Virmani R, Muller JE (2007) Frequency and distribution of thin-cap fibroatheroma and ruptured plaques in human coronary arteries: a pathologic study. J Am Coll Cardiol 50:940–949

    Article  PubMed  Google Scholar 

  30. Tanaka A, Shimada K, Namba M, Sakamoto T, Nakamura Y, Nishida Y, Yoshikawa J, Akasaka T (2008) Relationship between longitudinal morphology of ruptured plaques and TIMI flow grade in acute coronary syndrome: a three-dimensional intravascular ultrasound imaging study. Eur Heart J 29:38–44

    Article  PubMed  Google Scholar 

  31. Drake TA, Morrisey JH, Edgington TS (1989) Selective cellular expression of tissue factor in human tissues. Implications for disorders of hemostasis and thrombosis. Am J Pathol 134:1087–1097

    PubMed  CAS  Google Scholar 

  32. Davies MJ, Woolf N, Rowles PM, Pepper J (1988) Morphology of the endothelium over atherosclerotic plaques in human coronary arteries. Br Heart J 60:459–464

    Article  PubMed  CAS  Google Scholar 

  33. Libby P (2008) The molecular mechanism of the thrombotic complications of atherosclerosis. J Intern Med 263:517–527

    Article  PubMed  CAS  Google Scholar 

  34. Burke AP, Kolodgie FD, Farb A, Weber DK, Malcom GT, Smialek J, Virmani R (2001) Healed plaque ruptures and sudden coronary death: evidence that subclinical rupture has a role in plaque progression. Circulation 103:934–940

    PubMed  CAS  Google Scholar 

  35. Hong MK, Mintz GS, Lee CW, Suh IW, Hwang ES, Jeong YH, Park DW, Kim YH, Han KH, Cheong SS, Kim JJ, Park SW, Park SJ (2007) Serial intravascular ultrasound evidence of both plaque stabilization and lesion progression in patients with ruptured coronary plaques: effects of statin therapy on ruptured coronary plaque. Atherosclerosis 191:107–114

    Article  PubMed  CAS  Google Scholar 

  36. Rinker A, Nusser T, Grossmann G, Koenig W, Wöhrle J (2009) Angiographic results of a Tacrolimus-eluting stent in acute coronary syndrome lesions. Clin Res Cardiol 98:89–93

    Article  PubMed  CAS  Google Scholar 

  37. Böse D, Von Birgelen C, Zhou XY, Schmermund A, Philipp S, Sack S, Konorza T, Möhlenkamp S, Leineweber K, Kleinbongard P, Wijns W, Heusch G, Erbel R (2008) Impact of atherosclerotic plaque composition on coronary microembolization during percutaneous coronary interventions. Basic Res Cardiol 103:587–597

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Medizinische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Ziemssenstr. 1, Campus Innenstadt, 80336, Munich, Germany

    Andreas König, Johannes Rieber, Philip Jung, Thomas M. Schiele, Hae-Young Sohn, Marcus Leibig & Volker Klauss

  2. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway

    Øyvind Bleie

  3. Department of Public Health, Medical Decision Making and Health Assessment, Medical Informatics and Technology, University of Health Sciences, 6060, Hall, Austria

    Uwe Siebert

  4. Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Uwe Siebert

Authors
  1. Andreas König
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Øyvind Bleie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johannes Rieber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Philip Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thomas M. Schiele
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hae-Young Sohn
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marcus Leibig
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Uwe Siebert
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Volker Klauss
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andreas König.

Rights and permissions

Reprints and permissions

About this article

Cite this article

König, A., Bleie, Ø., Rieber, J. et al. Intravascular ultrasound radiofrequency analysis of the lesion segment profile in ACS patients. Clin Res Cardiol 99, 83–91 (2010). https://doi.org/10.1007/s00392-009-0077-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-009-0077-2

Keywords

Search

Navigation