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Thermal heterogeneity in stable human coronary atherosclerotic plaques is underestimated in vivo: the "cooling effect" of blood flow

^* Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece

View larger version (15K): [in a new window]   Figure 1 A summary of the sites of temperature measurements for the computation of Tl (difference between the atherosclerotic plaque and the proximal vessel wall) and Tp (difference between the proximal vessel wall temperature and the maximal temperature during complete flow interruption and after balloon deflation). After recording the temperature at the proximal vessel wall (PVW) at baseline, three measurements were obtained at the lesion: 1) at baseline, 2) during coronary flow interruption, and 3) after balloon deflation. Thus, Tl was obtained at these three phases of the study. Thereafter, temperature was recorded at the PVW: 1) during coronary blood flow interruption, and 2) after balloon deflation. The Tp was obtained at these two phases, respectively.

View larger version (126K): [in a new window]   Figure 2 An angiographic frame demonstrating the technique we used. In the proximal part, the balloon (B1) was inflated and temperature was recorded by the thermistor (Th) located distal to the balloon. The thermography catheter was advanced over a conventional floppy guidewire (GW) 0.014-in. in diameter. Distally, the Doppler guidewire (D-GW) is shown by which coronary flow velocity was continuously recorded.

View larger version (14K): [in a new window]   Figure 3 Difference between the proximal vessel wall temperature and the maximal temperature during complete flow interruption and after balloon deflation (Tp) (left) and difference of temperature (T) between the atherosclerotic plaque and the proximal vessel wall (Tl) at baseline, during complete occlusion of flow, and after balloon deflation (right). The bottom of the box represents the first quartile; the top of the box represents the third quartile, and the line in the box represents the median value of Tp or Tl. The broken vertical line differentiates the measurement for Tp and Tl.

View larger version (11K): [in a new window]   Figure 4 Graph showing the correlation between the difference of average peak velocity (AVP) from baseline values with Tl (difference of temperature between the atherosclerotic plaque and the proximal vessel wall) during balloon inflation.

View larger version (10K): [in a new window]   Figure 5 Difference between the atherosclerotic plaque and the proximal vessel wall (Tl) at baseline, during complete occlusion of flow, and after balloon deflation only in lesions in which no thermal heterogeneity (Tl <0.05°C) was detected at baseline. The bottom of the box represents the first quartile; the top of the box represents the third quartile, and the line in the box represents the median value of Tl.