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J Am Coll Cardiol, 2003; 41:403-408, doi:10.1016/S0735-1097(02)02817-6
© 2003 by the American College of Cardiology Foundation
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Thermal heterogeneity in stable human coronary atherosclerotic plaques is underestimated in vivo: the "cooling effect" of blood flow

Christodoulos Stefanadis, MD, FACC*,*, Konstantinos Toutouzas, MD*, Eleftherios Tsiamis, MD*, Ioannis Mitropoulos, MD*, Costas Tsioufis, MD*, Ioannis Kallikazaros, MD*, Christos Pitsavos, MD, FACC* and Pavlos Toutouzas, MD, FACC*

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



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  		Figure 1 A summary of the sites of temperature measurements for the computation of {Delta}Tl (difference between the atherosclerotic plaque and the proximal vessel wall) and {Delta}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, {Delta}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 {Delta}Tp was obtained at these two phases, respectively.

 


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  		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.

 


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  		Figure 3 Difference between the proximal vessel wall temperature and the maximal temperature during complete flow interruption and after balloon deflation ({Delta}Tp) (left) and difference of temperature ({Delta}T) between the atherosclerotic plaque and the proximal vessel wall ({Delta}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 {Delta}Tp or {Delta}Tl. The broken vertical line differentiates the measurement for {Delta}Tp and {Delta}Tl.

 


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  		Figure 4 Graph showing the correlation between the difference of average peak velocity (AVP) from baseline values with {Delta}Tl (difference of temperature between the atherosclerotic plaque and the proximal vessel wall) during balloon inflation.

 


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  		Figure 5 Difference between the atherosclerotic plaque and the proximal vessel wall ({Delta}Tl) at baseline, during complete occlusion of flow, and after balloon deflation only in lesions in which no thermal heterogeneity ({Delta}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 {Delta}Tl.

 




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Copyright © 2003 by the American College of Cardiology Foundation.