Thermal detection of vulnerable plaque
Thermal detection of vulnerable plaque
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DOI：
10.1016/s0002-9149(02)02962-4
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发表时间：
2002-11-21
影响因子：
2.8
通讯作者：
Casscells, W
中科院分区：
文献类型：
--
作者：
Madjid, M;Naghavi, M;Casscells, W
1996年，我们发现发炎的动脉粥样硬化斑块会释放更多的热量，而脆弱的斑块可以通过测量它们的温度来检测。斑块温度与炎性细胞密度直接相关，与细胞簇离管腔表面的距离成反比。它与平滑肌细胞的密度呈负相关。我们发现温度异质性与斑块中肺炎衣原体的存在或人类动脉粥样硬化颈动脉斑块的总体颜色之间没有显着相关性。我们还发现，从人颈动脉斑块和渡边动脉粥样硬化兔和载脂蛋白E缺陷小鼠的动脉粥样硬化的pH异质性。pH值较低的地区有较高的温度，与一个大的脂质核心的地区表现出较低的pH值与较高的温度，而钙化的地区有较低的温度和较高的pH值。我们还开发了一个热成像篮导管，并显示在体内的温度异质性动脉粥样硬化斑块和渡边兔的动脉粥样硬化病变。后来在人类动脉粥样硬化冠状动脉中记录了热异质性。动脉粥样硬化斑块与健康血管壁之间的温差与临床不稳定性有关。它与全身炎症标志物相关，是经皮介入治疗后不良心脏事件的强预测因子。热成像是一系列新颖的“功能”成像方法中的第一种，并正在进入临床试验。它可用于多种临床和研究目的，例如检测易损斑块和易损患者的危险分层。(C)2002年，Excerpta Medica，Inc.
In 1996, we showed that inflamed atherosclerotic plaques give off more heat and that vulnerable plaques may be detected by measuring their temperature. plaque temperature is correlated directly with inflammatory cell density and inversely with the distance of the cell clusters from the luminal surface. It is inversely related to the density of the smooth muscle cells. We found no significant association between temperature heterogeneity and presence of Chlamydia pneumoniae in plaque or the gross color of human atherosclerotic carotid plaques. We also found pH heterogeneity in plaques from human carotid artery and aortas of Watanabe atherosclerotic rabbits and apolipoprotein E-deficient mice. Areas with lower pH had higher temperature, and areas with a large lipid core showed lower pH with higher temperature, whereas calcified regions had lower temperature and higher pH. We also developed a thermography basket catheter and showed in vivo temperature heterogeneity in atherosclerotic lesions of atherosclerotic clogs and Watanabe rabbits. Thermal heterogeneity was later documented in human atherosclerotic coronary arteries. Temperature difference between atherosclerotic plaque and healthy vessel wall is related to clinical instability. It is correlated with systemic markers of inflammation and is a strong predictor of adverse cardiac events after percutaneous interventions. Thermography is the first in a series of novel "functional' imaging methods and is moving to clinical trials. it may be useful for a variety of clinical and research purposes, such as detection of vulnerable plaques and risk stratification of vulnerable patients. (C) 2002 by Excerpta Medica, Inc.