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Intracoronary Thermography for Detection of High-Risk Vulnerable Plaques

Mohammad Madjid, MD^_*,, James T. Willerson, MD, FACC^_*,,a and S. Ward Casscells, MD^_*,,a,_*

^_* University of Texas–Houston Health Science Center, Houston, Texas
St. Luke’s Episcopal Hospital/Texas Heart Institute, Houston, Texas

Manuscript received June 16, 2005; revised manuscript received October 15, 2005, accepted November 13, 2005.

^_* Reprint requests and correspondence: Dr. S. Ward Casscells, Office of Biotechnology, University of Texas Medical School at Houston, 7000 Fannin, UCT 795, Houston, Texas 77030 (Email: S.Ward.Casscells{at}uth.tmc.edu).

Up to two-thirds of acute myocardial infarctions develop at sites of culprit lesions without a significant stenosis. New imaging techniques are needed to identify those lesions with an increased risk of developing an acute complication in the near future. Inflammation is a hallmark feature of these vulnerable/high-risk plaques. We have shown that inflamed atherosclerotic plaques are hot and their surface temperature correlates with an increased number of macrophages and decreased fibrous-cap thickness. Multiple animal and human experiments have shown that temperature heterogeneity correlates with arterial inflammation in vivo. Several coronary temperature mapping catheters are currently being developed and studied. These thermography methods can be used in the future to detect vulnerable plaques, potentially to determine patients’ prognosis, and to study the plaque-stabilizing effects of different medications.

Abbreviations and Acronyms   AMI = acute myocardial infarction   ATP = adenosine triphosphate   CRP = C-reactive protein   EA = effort angina   IVUS = intravascular ultrasound   MMP = matrix metalloproteinase   Tmax = maximum temperature difference   UA = unstable angina   UCP = uncoupling protein

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