Intracoronary Laser Speckle Imaging for Atherosclerotic Plaque Diagnosis

冠状动脉内激光散斑成像用于动脉粥样硬化斑块诊断

• 批准号: 7392945
• 负责人: Seemantini K Nadkarni
• 金额: $ 25.38万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-20 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7392945
• 关键词: Acute; Address; Anatomy; Animal Model; Animals; Area; Arterial Fatty Streak; Arteries; Atherosclerosis; Back; Biomechanics; Blood flow; Cardiac; Cardiovascular Diseases; Catheterization; Catheters; Cause of Death; Clinical; Collagen; Condition; Coronary; Coronary Arteriosclerosis; Custom; Decompression Sickness; Detection; Development; Diagnosis; Diagnostic; Evaluation; Event; Family suidae; Feasibility Studies; Fiber; Goals; Human; Image; Imaging Device; Imaging Techniques; Imaging technology; Laboratories; Lasers; Life; Lighting; Link; Measurement; Measures; Mediating; Methods; Modeling; Morbidity - disease rate; Motion; Necrosis; Optics; Patients; Pattern; Performance; Physiological; Physiology; Process; Rate; Research; Research Proposals; Risk; Rupture; Screening procedure; Sensitivity and Specificity; Site; Societies; Specimen; Speed; Structure; System; Techniques; Technology; Testing; Thick; Thrombus; Time; Tissues; Translations; Work; Xenograft Model; Xenograft procedure; acute coronary syndrome; base; design; diagnostic accuracy; experience; heart motion; improved; in vivo; indexing; insight; instrumentation; light scattering; mortality; novel; optical fiber; particle; tissue phantom; tool; viscoelasticity

DESCRIPTION (provided by applicant): The rupture of unstable atherosclerotic plaque is the most frequent event leading to thrombus mediated ischemic cardiovascular disease, which remains the leading cause of mortality in industrialized societies. The processes leading to plaque vulnerability are multi-factorial, and it is widely conceived that an intricate interplay between biomechanical, compositional and morphological determinants of atherosclerosis influences plaque stability. The development of novel intracoronary imaging techniques that provide composite information about these factors is vital for identifying rupture-prone atherosclerotic plaques, guiding therapy, and for providing insights regarding plaque stabilization in patients. We recently showed that Laser Speckle Imaging (LSI), a new optical technique which measures the Brownian motion of endogenous particles in tissue, is highly sensitive for evaluating plaque viscoelasticity, composition and structure. Our prior work, conducted on cadaveric arterial specimens demonstrated that LSI has high accuracy for diagnosing atherosclerotic plaque type, measuring collagen content, and necrotic core area, and determining fibrous cap thickness. The goal of the current proposal is to develop an LSI system and catheter for in vivo intracoronary use. We envision that this work will potentially yield a single platform to evaluate coronary plaque biomechanics, composition and structure in patients. The Aims of this proposal are motivated by our prior experience in investigating the diagnostic potential of LSI and the expertise of our laboratory in fabricating miniature optical catheters for human use. Although we have demonstrated the principles of LSI ex vivo, the development of an intracoronary LSI catheter and system capable of imaging long coronary segments in vivo presents considerable technical challenges. In Aim 1 of this research we will focus on overcoming these challenges by developing LSI instrumentation and an intracoronary catheter capable of evaluating coronary vasculature in the presence of blood flow and cardiac motion. The diagnostic accuracy of LSI in identifying plaque type and characterizing structural features will be determined using ex vivo arterial tissue and phantom studies. In Aim 2 of this work we will demonstrate the feasibility of intracoronary LSI using a human to swine coronary xenograft living animal model to permit evaluation of human atherosclerotic plaques under in vivo physiological conditions. With the successful culmination of the aims of this proposal, we will have developed a novel intracoronary LSI technique and validated critical milestones in its path to clinical applicability.Narrative Acute coronary syndromes frequently result from the rupture of unstable coronary plaque. Intracoronary Laser Speckle Imaging will potentially provide a unique method to evaluate multiple determinants of plaque stability and facilitate the detection of high-risk coronary plaques in patients.

描述（由申请人提供）：不稳定动脉粥样硬化斑块的破裂是导致血栓介导的缺血性心血管疾病的最常见事件，这仍然是工业化社会中死亡的主要原因。导致斑块脆弱性的过程是多因素的，人们普遍认为动脉粥样硬化的生物力学、成分和形态决定因素之间错综复杂的相互作用会影响斑块的稳定性。新型冠状动脉内成像技术的发展可提供有关这些因素的综合信息，对于识别易于破裂的动脉粥样硬化斑块、指导治疗以及提供有关患者斑块稳定性的见解至关重要。我们最近表明，激光散斑成像（LSI）是一种测量组织中内源性颗粒布朗运动的新型光学技术，对于评估斑块粘弹性、成分和结构具有高度敏感性。我们之前对尸体动脉标本进行的工作表明，LSI 在诊断动脉粥样硬化斑块类型、测量胶原蛋白含量和坏死核心面积以及确定纤维帽厚度方面具有很高的准确性。当前提案的目标是开发用于体内冠状动脉内使用的 LSI 系统和导管。我们预计这项工作将有可能产生一个单一平台来评估患者冠状动脉斑块的生物力学、成分和结构。 该提案的目标是基于我们之前研究 LSI 诊断潜力的经验以及我们实验室在制造人类使用的微型光导管方面的专业知识。尽管我们已经在体外演示了 LSI 的原理，但开发能够在体内对长冠状动脉段进行成像的冠状动脉内 LSI 导管和系统面临着相当大的技术挑战。在本研究的目标 1 中，我们将通过开发 LSI 仪器和能够在存在血流和心脏运动的情况下评估冠状脉管系统的冠状动脉导管来克服这些挑战。 LSI 在识别斑块类型和表征结构特征方面的诊断准确性将通过离体动脉组织和模型研究来确定。在这项工作的目标 2 中，我们将证明使用人猪冠状动脉异种移植活体动物模型进行冠状动脉内 LSI 的可行性，以允许在体内生理条件下评估人类动脉粥样硬化斑块。随着该提案目标的成功实现，我们将开发出一种新型冠状动脉内 LSI 技术，并验证其临床应用道路上的关键里程碑。叙述 急性冠状动脉综合征常常是由不稳定冠状动脉斑块破裂引起的。冠状动脉内激光散斑成像将有可能提供一种独特的方法来评估斑块稳定性的多个决定因素，并促进患者高风险冠状动脉斑块的检测。