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(Circulation. 2003;108:e9066.)
© 2003 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

From This Week’s Circulation

Detecting Vulnerable Plaque
Intravascular elastography, the measurement of the elasticity of soft tissue by use of ultrasound, can detect vulnerable plaque with high sensitivity and specificity in the laboratory setting, said researchers from the Netherlands in this week’s issue of the journal Circulation ( Circulation. 2003;108:2636–2641[Abstract/Free Full Text]).

The researchers, led by Johannes A. Schaar, MD, Thoraxcenter Erasmus MC, in Rotterdam, the Netherlands, used intravascular elastography to investigate coronary artery specimens acquired from patients after death. The arteries were later processed for histological evaluation. Vulnerable plaque was defined histologically as having a thin cap of less than 250 µg, with moderate to great infiltration by macrophages and at least 40% of atheroma. By elastography, vulnerable plaque was plaque with a high-strain region at the surface surrounded by low-strain regions.

In 54 sections of 24 diseased coronary arteries, the researchers found 26 vulnerable plaques and 28 nonvulnerable plaques by histology. Twenty-three of the 26 histologically vulnerable plaques were also considered vulnerable by elastography. Of the 28 nonvulnerable plaques, 25 were detected by elastography. The researchers calculated that intravascular elastography has a positive predictive value of 88% and a negative predictive value of 89% compared with histology.

"There is a need for a technique to diagnose the vulnerability of a plaque," they wrote. "With the availability of such a technique, a vulnerable plaque can be identified and followed and treatment can be monitored. . . . Intravascular elastography identifies successfully vulnerable plaque features in postmortem coronary arteries. Thus, intravascular elastography may play an important role . . . [Full Text of this Article]