Abstract 12284: Quantified Coronary Frequency Domain Optical Coherence Tomography Signal Analysis for the Evaluation of Erythrocyte-Rich Thrombus: ex-vivo Validation Study
Introduction: Frequency domain optical coherence tomography (FDOCT) can detect the coronary thrombus. Previous study has shown that erythrocyte-rich thrombus (ERT) contains more inflammatory cells, leading to impaired myocardial reperfusion in myocardial infarction patients. We sought to investigate the utility of quantified FDOCT signal analysis in evaluating the ERT.
Methods: We evaluated 54 specimens of coronary artery thrombus obtained by thrombectomy from 9 patients (myocardial infarction: 8, stent thrombosis: 1) who underwent primary percutaneous coronary intervention. The thrombi were immersed in saline immediately after the thrombectomy and FDOCT image acquisition was performed during automatic-pull back (20 mm/s; 100 frames/s). Quantitative FDOCT analysis for all contiguous frames was performed by the dedicated automated software (OCT system software, Light Lab Inc.; figure). In each sample, signal intensity and normalized standard deviation of signal (NSD) were evaluated quantitatively for a frame showing the biggest thrombus area. All thrombi were stained using double staining of phosphotungstic acid - hematoxylin and eosin to enable automatic extraction of erythrocyte from fibrin. Computer-assisted analysis was performed using dedicated software (WinROOF, Mitani Corp., Tokyo, Japan; figure) for color identification of the erythrocyte area.
Results: ERT (N=8), defined as %erythrocyte area (erythrocyte area/total areaX100)≧10%, showed higher NSD / mean signal intensityX100 (4.55±0.53 vs. 3.82±0.70, p=0.007). The optimal cut-off point of NSD/mean signal intensityX100 for prediction of ERT was 4.08 (sensitivity: 87.5%, specificity: 63%, area under the receiver operating characteristic curve: 0.80, respectively).
Conclusions: The present ex-vivo study showed the utility of quantified FDOCT signal analysis on the detection of ERT. Quantified FDOCT signal analysis may scrutinize the pathogenesis of acute coronary syndrome.
- © 2013 by American Heart Association, Inc.