Abstract 16361: Detection of Plaque Neovascularization by Optical Coherence Tomography: ex-vivo Feasibility Study and in-vivo Observation in Patients with Angina Pectoris
Background: Plaque neovascularization may be related to plaque vulnerability. Purpose: The aims of this study were (1). to assess feasibility of optical coherence tomography (OCT) for detecting the neovascularization, and (2). to clarify impact of OCT detected plaque neovascularization on coronary vessel behavior over time.
Methods: (1). In the ex vivo study, 55 coronary plaques from 31 human cadavers were examined by OCT. Plaque neovascularization was diagnosed based on the presence or absence of microchannels (MC) by OCT. (2). In the in vivo study, 23 patients in whom intravascular ultrasound (IVUS) and OCT were serially performed (both at baseline and at follow-up) were included. Coronary plaques were selected from non-culprit (non-stented) lesions (plaque burden, >40% by IVUS). These coronary plaques were classified into 2 groups based on the presence or absence of MC (MC group, n=11, non-MC group, n=12).
Results: In the ex vivo study, the sensitivity and specificity of OCT to detect plaque neovascularization were 52% and 68%, respectively. In the in vivo study, %change (follow up - baseline) in lumen volume index in MC group was significantly greater than non-MC group (-12.2 ± 11.1 vs. 1.2 ± 8.1 %, p=0.006). Percent change in lumen volume index correlated significantly with %volume change in external elastic membrane volume index but not with %change in plaque plus media volume index (p=0.002, and p=0.217).
Conclusions: OCT is feasible for detecting neovascularization of coronary plaques. Coronary plaques with neovascularization showed greater luminal narrowing as a result of inadequate adaptive vessel remodeling.
- © 2012 by American Heart Association, Inc.