Abstract 10341: Contrast-Enhanced Ultrasound Overlay Imaging of Carotid Plaque Neovascularization is Useful for Identifying Risk for Acute Coronary Syndrome
Backgrounds: Contrast-enhanced ultrasound (CEUS) in the carotid arteries using microbubbles has been shown to be a potential technique for detecting the plaque neovascularization, a feature of unstable plaques. However, no quantitative CEUS method exists for determining the severity of plaque neovascularization. Thus, in the present study, we developed new CEUS quantification (CEUS score) methods and evaluated whether CEUS score may provide information for risk assessment of ACS.
Methods and results: CEUS of the carotid plaques using perfluorobutane microbubbles as an ultrasound contrast agent were performed in consecutive 241 patients with suspected of acute coronary syndrome. By integrating the exposure for an extended period, we can produce an overlay imaging of the microbubbles, revealing their trajectories. Intra-plaque neovascularization identified as high echoic area were evaluated by the overlay imaging and quantified as gray scale median values. Of all study patients, 74 patients were diagnosed as ACS according to guideline. CEUS study showed that higher gray scale median values were observed in patients with ACS than those without ACS (26 +/-16 vs17 +/- 13, p<0.05). Moreover, multiple logistic regression test showed that higher CEUS score were a significant and independent risk factor for the presence of ACS after adjustement for LDL-C, non-HDL-C, and CRP levels (OR 1.58, 95% CI 1.27-1.97 , p<0.05). Subgroup analysis showed treatment with atorvastatin (n = 15) for 6 months significantly reduced LDL-C and CRP levels, with a concomitant decrease in CEUS score (34.7 +/- 11 at baseline, vs. 11.2 +/- 9.3 at 6 months, p<0.05). The % decrease in CEUS score from baseline were significantly correlated with the magnitude of improvement in LDL-C and CRP levels (r = 0.44 , p <0.05, in LDL-C, r = 0.49 , p <0.05, in CRP).
Conclusions: Quantitative assessment of carotid plaque neovascularization by the contrast-enhanced ultrasound may be useful for risk assessment of ACS.
- © 2013 by American Heart Association, Inc.