HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kawasaki, M. Articles by Fujiwara, H. Search for Related Content PubMed PubMed Citation Articles by Kawasaki, M. Articles by Fujiwara, H. Related Collections Related Article

CLINICAL RESEARCH: INTRAVASCULAR IMAGING AND VULNERABLE PLAQUE

Volumetric Quantitative Analysis of Tissue Characteristics of Coronary Plaques After Statin Therapy Using Three-Dimensional Integrated Backscatter Intravascular Ultrasound

Masanori Kawasaki, MD, PhD^_*,_*, Keiji Sano, MD, PhD^_*, Munenori Okubo, MD^_*, Haruko Yokoyama, MD^_*, Yoko Ito, MD, PhD^_*, Ichijiro Murata, MD, PhD^_*, Kunihiko Tsuchiya, MD, PhD^_*, Shinya Minatoguchi, MD, PhD^_*, Xiangrong Zhou, PhD, Hiroshi Fujita, PhD and Hisayoshi Fujiwara, MD, PhD^_*

^_* Regeneration and Advanced Medical Science, Gifu University Graduate School of Medicine, Gifu, Japan
Department of Intelligent Image Information, Gifu University Graduate School of Medicine, Gifu, Japan

Manuscript received May 24, 2004; revised manuscript received August 14, 2004, accepted September 17, 2004.

^_* Reprint requests and correspondence: Dr. Masanori Kawasaki, Regeneration and Advanced Medical Science, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan (Email: masanori{at}ya2.so-net.ne.jp).

OBJECTIVES: The purpose of the present study was twofold: 1) to evaluate the usefulness of three-dimensional (3D) integrated backscatter (IB) intravascular ultrasound (IVUS) for quantitative tissue characterization of coronary plaques; and 2) to use this imaging technique to determine if six months of statin therapy alters the tissue characteristics of coronary plaques.

BACKGROUND: Three-dimensional IVUS techniques for quantitative tissue characterization of plaque composition have not been developed.

METHODS: Radiofrequency (RF) signals were obtained using an IVUS system with a 40-MHz catheter. The IB values of the RF signal were calculated and color-coded. The 3D reconstruction of the color-coded map was performed by computer software. A total of 18 IB IVUS images were captured at an interval of 1 mm in each plaque. A total of 52 patients with hyperlipidemia were randomized to treatment with pravastatin (20 mg/day, n = 17), atorvastatin (20 mg/day, n = 18), or diet (n = 17) for six months. The tissue characteristics of arterial plaque in each patient (one arterial segment per patient) were analyzed with 3D IB IVUS before and after treatment.

RESULTS: Significant increases of fibrous volume (pravastatin: 25.4 ± 6.5% to 28.1 ± 6.1%; atorvastatin: 26.2 ± 5.7% to 30.1 ± 5.5%) and mixed lesion volume (atorvastatin: 25.5 ± 6.6% to 28.7 ± 5.1%) and a reduction of lipid volume (pravastatin: 25.5 ± 5.7% to 21.9 ± 5.3%; atorvastatin: 26.5 ± 5.2% to 19.9 ± 5.5%) were observed after statin therapy.

CONCLUSIONS: Statin therapy reduced the lipid component in patients with stable angina without reducing the degree of stenosis. Three-dimensional IB IVUS offers the potential for quantitative volumetric tissue characterization of coronary atherosclerosis.

Abbreviations and Acronyms   2D = two-dimensional   3D = three-dimensional   DM = diabetes mellitus   ECG = electrocardiogram/electrocardiographic   HL = hyperlipidemia   HTN = hypertension   IB = integrated backscatter   IVUS = intravascular ultrasound   RF = radiofrequency   ROI = region of interest

Related Article

Picking Plaques That Pop ...

Jagat Narula, Aloke V. Finn, and Anthony N. DeMaria
J. Am. Coll. Cardiol. 2005 45: 1970-1973. [Full Text] [PDF]

This article has been cited by other articles:

				F. Alfonso and L. Hernando Intravascular ultrasound tissue characterization. I like the rainbow but... what's behind the colours? Eur. Heart J., July 2, 2008; 29(14): 1701 - 1703. [Full Text] [PDF]

				S. H. Choi, A. Chae, E. Miller, M. Messig, F. Ntanios, A. N. DeMaria, S. E. Nissen, J. L. Witztum, and S. Tsimikas Relationship Between Biomarkers of Oxidized Low-Density Lipoprotein, Statin Therapy, Quantitative Coronary Angiography, and Atheroma Volume Observations From the REVERSAL (Reversal of Atherosclerosis with Aggressive Lipid Lowering) Study. J. Am. Coll. Cardiol., July 1, 2008; 52(1): 24 - 32. [Abstract] [Full Text] [PDF]

				Y. Honda and P. J. Fitzgerald Frontiers in Intravascular Imaging Technologies Circulation, April 15, 2008; 117(15): 2024 - 2037. [Full Text] [PDF]

				A. Tanaka, K. Shimada, M. Namba, T. Sakamoto, Y. Nakamura, Y. Nishida, J. Yoshikawa, and T. Akasaka 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., January 1, 2008; 29(1): 38 - 44. [Abstract] [Full Text] [PDF]

				S. K. Mehta, J. R. McCrary, A. D. Frutkin, W. J.S. Dolla, and S. P. Marso Intravascular ultrasound radiofrequency analysis of coronary atherosclerosis: an emerging technology for the assessment of vulnerable plaque Eur. Heart J., June 1, 2007; 28(11): 1283 - 1288. [Abstract] [Full Text] [PDF]

				T. Amano, T. Matsubara, T. Uetani, M. Nanki, N. Marui, M. Kato, K. Arai, K. Yokoi, H. Ando, H. Ishii, et al. Impact of Metabolic Syndrome on Tissue Characteristics of Angiographically Mild to Moderate Coronary Lesions: Integrated Backscatter Intravascular Ultrasound Study J. Am. Coll. Cardiol., March 20, 2007; 49(11): 1149 - 1156. [Abstract] [Full Text] [PDF]

				S. Waxman, F. Ishibashi, and J. E. Muller Detection and Treatment of Vulnerable Plaques and Vulnerable Patients: Novel Approaches to Prevention of Coronary Events Circulation, November 28, 2006; 114(22): 2390 - 2411. [Full Text] [PDF]

				S. J. Nicholls, E. M. Tuzcu, I. Sipahi, P. Schoenhagen, and S. E. Nissen Intravascular Ultrasound in Cardiovascular Medicine Circulation, July 25, 2006; 114(4): e55 - e59. [Full Text] [PDF]

				M. Kawasaki, B. E. Bouma, J. Bressner, S. L. Houser, S. K. Nadkarni, B. D. MacNeill, I.-K. Jang, H. Fujiwara, and G. J. Tearney Diagnostic Accuracy of Optical Coherence Tomography and Integrated Backscatter Intravascular Ultrasound Images for Tissue Characterization of Human Coronary Plaques J. Am. Coll. Cardiol., July 4, 2006; 48(1): 81 - 88. [Abstract] [Full Text] [PDF]

				A. N. DeMaria, J. Narula, E. Mahmud, and S. Tsimikas Imaging vulnerable plaque by ultrasound. J. Am. Coll. Cardiol., April 18, 2006; 47(8 Suppl): C32 - C39. [Abstract] [Full Text] [PDF]

				K. Sano, M. Kawasaki, Y. Ishihara, M. Okubo, K. Tsuchiya, K. Nishigaki, X. Zhou, S. Minatoguchi, H. Fujita, and H. Fujiwara Assessment of Vulnerable Plaques Causing Acute Coronary Syndrome Using Integrated Backscatter Intravascular Ultrasound J. Am. Coll. Cardiol., February 21, 2006; 47(4): 734 - 741. [Abstract] [Full Text] [PDF]

				A. N. DeMaria, O. Ben-Yehuda, D. Berman, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, W. Y.W. Lew, D. Sahn, and S. Tsimikas Highlights of the Year in JACC 2005 J. Am. Coll. Cardiol., January 3, 2006; 47(1): 184 - 202. [Full Text] [PDF]

				J. Narula, A. V. Finn, and A. N. DeMaria Picking Plaques That Pop ... J. Am. Coll. Cardiol., June 21, 2005; 45(12): 1970 - 1973. [Full Text] [PDF]