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.
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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 |
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