Volumetric quantitative analysis of tissue characteristics of coronary plaques after statin therapy using three-dimensional integrated backscatter intravascular ultrasound
Volumetric quantitative analysis of tissue characteristics of coronary plaques after statin therapy using three-dimensional integrated backscatter intravascular ultrasound
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DOI：
10.1016/j.jacc.2004.09.081
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发表时间：
2005-06-21
影响因子：
24
通讯作者：
Fujiwara, H
中科院分区：
文献类型：
--
作者：
Kawasaki, M;Sano, K;Fujiwara, H
本研究的目的有两个：1）评价三维（3D）背向散射积分（IB）血管内超声（IVUS）对冠状动脉斑块定量组织定征的有用性;以及2）使用这种成像技术来确定六个月的他汀类药物治疗是否改变了冠状动脉斑块的组织特征。还没有开发用于斑块组成的定量组织表征的三维IVUS技术。方法使用具有40-MHz导管的IVUS系统获得放射性（RF）信号。计算RF信号的IB值并进行颜色编码。用计算机软件对彩色编码图进行三维重建。在每个斑块中以1 mm的间隔共捕获18个IB IVUS图像。共52例高脂血症患者随机接受普伐他汀（20 mg/d，n = 17）、阿托伐他汀（20 mg/d，n = 18）或饮食（n = 17）治疗6个月。每例患者动脉斑块的组织特征治疗前后用3D IB血管内超声（3D IB IVUS）对每例患者的一个动脉段进行分析。（普伐他汀：25.4 ± 6.5%至28.1 ± 6.1%;阿托伐他汀：26.2 ± 5.7%至30.1 ± 5.5%）和混合病灶体积（阿托伐他汀：25.5 +/-6.6%至28.7 +/-5.1%）和脂质体积减少（普伐他汀：25.5 +/-5.7%至21.9 +/-5.3%;阿托伐他汀：26.5 ± 5.2%至19.9 ± 5.5%.CONCLUSIONS他汀类药物治疗可降低稳定型心绞痛患者的脂质成分，但不降低狭窄程度。三维IB IVUS为冠状动脉粥样硬化的定量体积组织表征提供了可能。(c)2005年，美国心脏病学会基金会。
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. (c) 2005 by the American College of Cardiology Foundation.