Intravascular microstructural, chemical and biomechanical characterization of coronary plaques

在美国，心脏病是主要的死亡原因；最常见的心脏病类型是 动脉粥样硬化，血管壁增厚，形成动脉粥样硬化斑块。血管内 光学相干断层扫描(IV-OCT)使冠状动脉结构的成像成为可能。 先例细节，可用于评估经皮冠状动脉介入治疗的反应 在治疗动脉粥样硬化病变时。然而，仍有必要评估斑块VUL- 神经功能：确定哪些轻微的损伤可能在未来导致心脏事件， 因此需要立即采取预防性干预措施。在病变类型中，薄帽纤维型 肉瘤(TCFA)尤其令人担忧，因为他们被认为有更高的RUP风险- 没错；然而，研究发现，只有一小部分TCFA破裂。尽管有可能 断裂与其机械稳定性、化学成分和微观结构有关， 目前还没有能够对单个患者的斑块进行生物力学分析的技术。 在干预期间[不需要耗时的有限元建模]和 现有的测定成分的方法要么缺乏特异性，要么缺乏空间分辨率。 为了解决当前血管内成像技术无法满足的这一重大需求，我们将开发一种 全光学成像平台，将深刻拓宽获得精确生物力学、化学和化学的途径 个体患者冠状动脉斑块的CAL和微结构分析。我们的新平台将- 能够在当前的全面斑块表征能力上实现革命性飞跃，在- 包括斑块成分和易损性的评估。我们将利用新的超快激光 消息来源以每秒2,000帧的速度开发IV-OCT，实现了一系列强大的后处理 这项技术将增强斑块的全面表征。在目标1中，我们将制定 使硬件能够实现高速血管内成像。在目标2中，我们将开发硬件和 信号处理，以实现10×302微米3(深度×横向)尺度的微结构剖析，化学 80×802微米尺度的剖析和60×602微米尺度的全光学生物力学剖析 技术，不需要有限元分析。在目标3中，我们将开发一个基于 人体心脏跳动生物力学环境的软机器人心脏模拟器。 我们的单一成像平台将促进临床研究，以确定斑块普通人的参数- 能力，为确定最佳治疗策略打开了大门。最初，它将成为一种 动脉粥样硬化的宝贵研究工具；以后，它将有可能指导对动脉粥样硬化的干预。 看不见的病人。在完成技术开发后，在拟议资金结束时 周期，我们的平台将准备好在人体上进行测试。

Heart disease is the leading cause of death in the US; the most prevalent type of heart disease is caused by atherosclerosis, the thickening of the vessel wall and creation of atherosclerotic plaque. Intravascular optical coherence tomography (IV-OCT) has enabled the imaging of coronary artery structures with un- precedented detail, and can be used to evaluate the response to percutaneous coronary intervention when treating atherosclerotic lesions. However, there remains a significant need to assess plaque vul- nerability: the determination of which mild lesions are likely to produce cardiac events in the future, and thus require immediate preventative interventional measures. Among lesion types, thin-cap fi- broatheromas (TCFA) are of particular concern since they are believed to be at increased risk of rup- ture; however, studies have found that only a fraction of TCFAs rupture. Although the likelihood of rupture has been linked to its mechanical stability, its chemical composition, and its microstructure, there is currently no technology capable of the biomechanical profiling of plaques in individual patients during intervention [without the need for time-consuming finite element modeling (FEM)] and the available methods for determining composition either lack specificity or spatial resolution. To address this significant need unmet by current intravascular imaging technology, we will develop an all-optical imaging platform that will profoundly broaden the access to accurate biomechanical, chemi- cal and microstructural profiling of coronary plaques in individual patients. Our novel platform will en- able a transformational leap in the current capability for comprehensive plaque characterization, in- cluding the assessment of plaque composition and vulnerability. We will leverage new ultra-fast laser sources to develop IV-OCT at 2,000 frames per second, enabling a host of powerful post-processing techniques that will enhance comprehensive characterization of plaques. In Aim 1 we will develop the enabling hardware to realize high-speed intravascular imaging. In Aim 2 we will develop hardware and signal processing to enable microstructural profiling at the 10×302 µm3 (depth×lateral) scale, chemical profiling at the 80×802 µm3 scale, and biomechanical profiling at the 60×602 µm3 scale in an all-optical technique without the need for FEM. In Aim 3 we will develop a novel validation platform based on a soft-robotics cardiac simulator of the biomechanical environment of the human beating heart. Our single imaging platform will facilitate clinical studies to determine the parameters of plaque vulner- ability, opening the door to the identification of optimal treatment strategies. Initially, it will become an invaluable research tool in atherosclerosis; later, it will have the potential to guide intervention in indi- vidual patients. After completion of the technological developments at the end of the proposed funding cycle, our platform will be ready for testing in human subjects.