1
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Cesaro A, Acerbo V, Indolfi C, Filardi PP, Calabrò P. The clinical relevance of the reversal of coronary atherosclerotic plaque. Eur J Intern Med 2024:S0953-6205(24)00348-0. [PMID: 39164156 DOI: 10.1016/j.ejim.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/12/2024] [Accepted: 08/11/2024] [Indexed: 08/22/2024]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of death globally despite advances in preventive therapies. Understanding of the initiation and progression of atherosclerosis, the interplay between lipoproteins, endothelial dysfunction, inflammation, and immune responses is critical to treating this disease. The development of vulnerable coronary plaques prone to thrombosis, can lead to acute coronary syndromes, for these reasons, the potential plaque stabilization and regression through pharmacological interventions, particularly lipid-lowering agents like statins and PCSK9 inhibitors is crucial. The imaging techniques such as intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and optical coherence tomography (OCT) play a key role in assessing plaque composition and guiding interventional therapeutic strategies. Clinical evidence supports the efficacy of intensive lipid-lowering therapy in inducing plaque regression, with studies demonstrating reductions in plaque volume and improvements in plaque morphology assessed by IVUS, OCT and NIRS. While pharmacological interventions show promise in promoting plaque regression and stabilization, their impact on long-term cardiovascular events requires further investigation. Multimodality imaging and comprehensive outcome trials are proposed as essential tools for elucidating the relationship between plaque modification and clinical benefit in coronary atherosclerosis. The stabilization or regression of atherosclerotic plaque might serve as the phenomenon linking the reduction in LDL-C levels to the decrease in cardiovascular events. Overall, this review emphasizes the ongoing efforts to advance our understanding of ASCVD pathophysiology and optimize therapeutic approaches for improving patient outcomes.
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Affiliation(s)
- Arturo Cesaro
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy
| | - Vincenzo Acerbo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | | | - Paolo Calabrò
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy.
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2
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Sarraju A, Nissen SE. Atherosclerotic plaque stabilization and regression: a review of clinical evidence. Nat Rev Cardiol 2024; 21:487-497. [PMID: 38177454 DOI: 10.1038/s41569-023-00979-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 01/06/2024]
Abstract
Atherosclerotic plaque results from a complex interplay between lipid deposition, inflammatory changes, cell migration and arterial wall injury. Over the past two decades, clinical trials utilizing invasive arterial imaging modalities, such as intravascular ultrasonography, have shown that reducing levels of atherogenic lipoproteins, mainly serum LDL-cholesterol (LDL-C), to very low levels can safely reduce overall atherosclerotic plaque burden and favourably modify plaque composition. Classically, this outcome has been achieved with intensive statin therapy. Since 2016, newer and potent lipid-lowering strategies, such as proprotein convertase subtilisin-kexin type 9 inhibition, have shown incremental effects on plaque regression and risk of clinical events. Despite maximal reduction in plasma LDL-C levels, considerable residual cardiovascular risk remains in some patients. Therefore, there is a need to study therapeutic approaches that address residual risk beyond LDL-C reduction to promote plaque stabilization or regression. Contemporary imaging modalities, such as coronary computed tomography angiography, enable non-invasive assessment of the overall atherosclerotic plaque burden as well as of certain local plaque characteristics. This technology could allow further study of plaque stabilization and regression using novel therapeutic approaches. Non-invasive plaque assessment might also offer the potential to guide personalized management strategies if validated for this purpose.
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Affiliation(s)
- Ashish Sarraju
- Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Steven E Nissen
- Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
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3
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Chen Y, Tung HF, Hwang JF. Infrared images help to identify retinal emboli in hemodynamic retinal artery occlusion. Taiwan J Ophthalmol 2024; 14:137-139. [PMID: 38654982 PMCID: PMC11034682 DOI: 10.4103/tjo.tjo-d-22-00166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/12/2023] [Indexed: 04/26/2024] Open
Abstract
To report a case of stroke with internal carotid artery (ICA) occlusion and retinal artery occlusion (RAO) with multiple emboli identified by infrared images. The patient presented with acute blurred vision and slurred speech since woke up in the morning. Carotid Doppler ultrasonography showed severe left ICA stenosis with the decreased flow. Computed tomography angiography demonstrated left ICA critical stenosis with compensatory flows from the right ICA. There was coexistent RAO with multiple emboli, silver-wiring, and segmentation of the retinal artery. More hyperreflective emboli were uncovered by infrared images of spectral-domain optical coherence tomography. Embolism may accompany with the compensatory flow for ICA occlusion. RAO patients should have thorough carotid evaluations, especially those with multiple retinal emboli.
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Affiliation(s)
- Yu Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsiao-Fan Tung
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
| | - Jiunn-Feng Hwang
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
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4
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Nafee T, Shah A, Forsberg M, Zheng J, Ou J. State-of-art review: intravascular imaging in percutaneous coronary interventions. CARDIOLOGY PLUS 2023; 8:227-246. [PMID: 38304487 PMCID: PMC10829907 DOI: 10.1097/cp9.0000000000000069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/05/2023] [Indexed: 02/03/2024] Open
Abstract
The history of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) reflects the relentless pursuit of innovation in interventional cardiology. These intravascular imaging technologies have played a pivotal role in our understanding of coronary atherosclerosis, vascular pathology, and the interaction of coronary stents with the vessel wall. Two decades of clinical investigations demonstrating the clinical efficacy and safety of intravascular imaging modalities have established these technologies as staples in the contemporary cardiac catheterization lab's toolbox and earning their place in revascularization clinical practice guidelines. In this comprehensive review, we will delve into the historical evolution, mechanisms, and technical aspects of IVUS and OCT. We will discuss the expanding evidence supporting their use in complex percutaneous coronary interventions, emphasizing their crucial roles in optimizing patient outcomes and ensuring procedural success. Furthermore, we will explore the substantial advances that have propelled these imaging modalities to the forefront of contemporary interventional cardiology. Finally, we will survey the latest developments in the field and explore the promising future directions that have the potential to further revolutionize coronary interventions.
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Affiliation(s)
- Tarek Nafee
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
| | - Areeb Shah
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
| | - Michael Forsberg
- Cardiovascular Division, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
| | - Jingsheng Zheng
- Department of Cardiology, AtlantiCare Regional Medical Center, Pomona, NJ 08240, USA
| | - Jiafu Ou
- The Division of Cardiology, Department of Medicine, John Cochran Veterans Affairs Medical Center, St. Louis, MO 63106, USA
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
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5
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Seguchi M, Aytekin A, Lenz T, Nicol P, Klosterman GR, Beele A, Sabic E, Utsch L, Alyaqoob A, Gorpas D, Ntziachristos V, Jaffer FA, Rauschendorfer P, Joner M. Intravascular molecular imaging: translating pathophysiology of atherosclerosis into human disease conditions. Eur Heart J Cardiovasc Imaging 2022; 24:e1-e16. [PMID: 36002376 DOI: 10.1093/ehjci/jeac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/31/2022] [Indexed: 12/25/2022] Open
Abstract
Progression of atherosclerotic plaque in coronary arteries is characterized by complex cellular and non-cellular molecular interactions. Within recent years, atherosclerosis has been recognized as inflammation-driven disease condition, where progressive stages are characterized by morphological changes in plaque composition but also relevant molecular processes resulting in increased plaque vulnerability. While existing intravascular imaging modalities are able to resolve key morphological features during plaque progression, they lack capability to characterize the molecular profile of advanced atherosclerotic plaque. Because hybrid imaging modalities may provide incremental information related to plaque biology, they are expected to provide synergistic effects in detecting high risk patients and lesions. The aim of this article is to review existing literature on intravascular molecular imaging approaches, and to provide clinically oriented proposals of their application. In addition, we assembled an overview of future developments in this field geared towards detection of patients at risk for cardiovascular events.
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Affiliation(s)
- Masaru Seguchi
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Alp Aytekin
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Tobias Lenz
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Philipp Nicol
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Grace R Klosterman
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Alicia Beele
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Emina Sabic
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Léa Utsch
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Aseel Alyaqoob
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany
| | - Dimitris Gorpas
- Chair of Biological Imaging and TranslaTUM, Technical University of Munich, Munich 80333, Germany.,Institute of Biological and Medical Imaging, Helmholtz Zentrum München GmbH, Neuherberg 85764, Germany
| | - Vasilis Ntziachristos
- Chair of Biological Imaging and TranslaTUM, Technical University of Munich, Munich 80333, Germany.,Institute of Biological and Medical Imaging, Helmholtz Zentrum München GmbH, Neuherberg 85764, Germany.,Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich 80336, Germany
| | - Farouc A Jaffer
- Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Philipp Rauschendorfer
- Chair of Biological Imaging and TranslaTUM, Technical University of Munich, Munich 80333, Germany.,Institute of Biological and Medical Imaging, Helmholtz Zentrum München GmbH, Neuherberg 85764, Germany.,Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich 80336, Germany
| | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich 80636, Germany.,Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich 80336, Germany
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6
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Lee H, Seeger MR, Lippok N, Nadkarni SK, van Soest G, Bouma BE. Nanosecond SRS fiber amplifier for label-free near-infrared photoacoustic microscopy of lipids. PHOTOACOUSTICS 2022; 25:100331. [PMID: 35096525 PMCID: PMC8783138 DOI: 10.1016/j.pacs.2022.100331] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/05/2022] [Accepted: 01/14/2022] [Indexed: 05/18/2023]
Abstract
Near-infrared photoacoustics receives increasing interest as an intravital modality to sense key biomolecules. One of the most central types of biomolecules of interest are lipids as they constitute essential bio-hallmarks of cardiovascular and metabolic diseases and their in-vivo detection holds insightful information about disease progression and treatment monitoring. However, the full potential of near-infrared photoacoustic for high-resolution and high-sensitivity biomedical studies of lipids has so far not been exploited due a lack of appropriate excitation sources delivering short-pulses at high-repetition-rate, high-pulse-energy, and wavelength around 1200 nm. Here, we demonstrate a custom-built SRS fiber amplifier that provides optical excitations at 1192.8 nm, repetition rates of 200 kHz, pulse durations below 2 ns, and pulse energies beyond 5 μJ. We capitalize on the performance of our excitation source and show near-infrared photoacoustics resolving intrinsic lipid contrast in biomedically relevant specimens ranging from single cells to lipid-rich tissue with subcellular resolution.
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Affiliation(s)
- Hwidon Lee
- Harvard Medical School, Boston, Massachusetts, MA 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
| | - Markus R. Seeger
- Harvard Medical School, Boston, Massachusetts, MA 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
| | - Norman Lippok
- Harvard Medical School, Boston, Massachusetts, MA 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
| | - Seemantini K. Nadkarni
- Harvard Medical School, Boston, Massachusetts, MA 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
| | - Gijs van Soest
- Department of Biomedical Engineering, Erasmus Medical Center, PO Box 2040, 3000 Rotterdam, CA The Netherlands
| | - Brett E. Bouma
- Harvard Medical School, Boston, Massachusetts, MA 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
- Department of Biomedical Engineering, Erasmus Medical Center, PO Box 2040, 3000 Rotterdam, CA The Netherlands
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
- Corresponding author at: Harvard Medical School, Boston, Massachusetts, MA 02115, USA.
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7
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Xie Z, Shu C, Yang D, Chen H, Chen C, Dai G, Lam KH, Zhang J, Wang X, Sheng Z, Gao D, Liu C, Song L, Gong X. In vivo intravascular photoacoustic imaging at a high speed of 100 frames per second. BIOMEDICAL OPTICS EXPRESS 2020; 11:6721-6731. [PMID: 33282520 PMCID: PMC7687943 DOI: 10.1364/boe.405792] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/21/2020] [Accepted: 10/03/2020] [Indexed: 05/02/2023]
Abstract
Intravascular photoacoustic (IVPA) imaging technology enables the visualization of pathological characteristics (such as inflammation activities, lipid deposition) of the artery wall. Blood flushing is a necessary step in improving the imaging quality in in vivo IVPA imaging. But the limited imaging speed of the systems stretches their flushing time, which is an important obstacle of their clinical translations. In this paper, we report an improvement in IVPA/IVUS imaging speed to 100 frames per second. The high-speed imaging is demonstrated in rabbit in vivo, visualizing the nanoparticles accumulated on abdominal aorta wall at the wavelength of 1064 nm, in real time display. Blood flushing in vivo improves the IVPA signal-noise-ratio by around 3.5 dB. This study offers a stable, efficient and easy-to-use tool for instantaneous disease visualization and disease diagnosis in research and forwards IVPA/IVUS imaging technology towards clinical translations.
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Affiliation(s)
- Zhihua Xie
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
- Equal contribution
| | - Chengyou Shu
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
- Equal contribution
| | - Daya Yang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
- Key Laboratory of Assisted Circulation, National Health Commission, Sun Yat-sen University, Guangzhou 510080, China
- Equal contribution
| | - Hao Chen
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Chaobin Chen
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Gang Dai
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
- Key Laboratory of Assisted Circulation, National Health Commission, Sun Yat-sen University, Guangzhou 510080, China
| | - Kwok Ho Lam
- Department of Electrical Engineering, The Hong Kong Polytechnic University, Hunghom, Hong Kong
| | - Jinke Zhang
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
| | - Xiatian Wang
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Zonghai Sheng
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
| | - Duyang Gao
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
| | - Chengbo Liu
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
| | - Liang Song
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
| | - Xiaojing Gong
- Research Laboratory for Biomedical Optics and Molecular imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Research Laboratory for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
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8
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Fedewa R, Puri R, Fleischman E, Lee J, Prabhu D, Wilson DL, Vince DG, Fleischman A. Artificial Intelligence in Intracoronary Imaging. Curr Cardiol Rep 2020; 22:46. [DOI: 10.1007/s11886-020-01299-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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9
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Galassi TV, Jena PV, Shah J, Ao G, Molitor E, Bram Y, Frankel A, Park J, Jessurun J, Ory DS, Haimovitz-Friedman A, Roxbury D, Mittal J, Zheng M, Schwartz RE, Heller DA. An optical nanoreporter of endolysosomal lipid accumulation reveals enduring effects of diet on hepatic macrophages in vivo. Sci Transl Med 2019; 10:10/461/eaar2680. [PMID: 30282694 DOI: 10.1126/scitranslmed.aar2680] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 04/05/2018] [Accepted: 09/10/2018] [Indexed: 12/15/2022]
Abstract
The abnormal accumulation of lipids within the endolysosomal lumen occurs in many conditions, including lysosomal storage disorders, atherosclerosis, nonalcoholic fatty liver disease (NAFLD), and drug-induced phospholipidosis. Current methods cannot monitor endolysosomal lipid content in vivo, hindering preclinical drug development and research into the mechanisms linking endolysosomal lipid accumulation to disease progression. We developed a single-walled carbon nanotube-based optical reporter that noninvasively measures endolysosomal lipid accumulation via bandgap modulation of its intrinsic near-infrared emission. The reporter detected lipid accumulation in Niemann-Pick disease, atherosclerosis, and NAFLD models in vivo. By applying the reporter to the study of NAFLD, we found that elevated lipid quantities in hepatic macrophages caused by a high-fat diet persist long after reverting to a normal diet. The reporter dynamically monitored endolysosomal lipid accumulation in vivo over time scales ranging from minutes to weeks, indicating its potential to accelerate preclinical research and drug development processes.
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Affiliation(s)
- Thomas V Galassi
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Weill Cornell Medicine, New York, NY 10065, USA
| | - Prakrit V Jena
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Janki Shah
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Geyou Ao
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Elizabeth Molitor
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Yaron Bram
- Weill Cornell Medicine, New York, NY 10065, USA
| | | | - Jiwoon Park
- Weill Cornell Medicine, New York, NY 10065, USA
| | | | - Daniel S Ory
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | - Daniel Roxbury
- Department of Chemical Engineering, University of Rhode Island, Kingston, RI 02881, USA
| | - Jeetain Mittal
- Department of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, PA 18015, USA
| | - Ming Zheng
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | | | - Daniel A Heller
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. .,Weill Cornell Medicine, New York, NY 10065, USA
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10
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Shrestha R, Shrestha A, Kan J, Chen S. A review in enormity of OCT and its enduring understanding of vulnerable plaque in coronary bifurcation lesion. Int J Cardiovasc Imaging 2018; 34:1679-1684. [PMID: 29858960 DOI: 10.1007/s10554-018-1384-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 05/26/2018] [Indexed: 01/03/2023]
Abstract
Optical coherence tomography (OCT) has emerged as one of the most promising tools to assist the optimization of percutaneous coronary intervention (PCI). Its ability to provide unique information on the plaque at high risk for rupture, plaque composition, the thickness of the fibrous cap, the presence of macrophage and thrombi has not only assisted simple PCI but also in many complex bifurcation lesions PCI. OCT has helped to provide valuable anatomic information to optimize stent implantation and adapt PCI strategy in individual patients. This review article summarizes the current role of OCT as an imaging technology and prediction of vulnerable plaque, its site and composition at the coronary bifurcation lesions for supporting the clinical decision.
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Affiliation(s)
| | | | - Jing Kan
- Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Shaoliang Chen
- Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
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11
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12
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Rajesh B, Hussain R, Giridhar A. Autofluorescence and Infrared Fundus Imaging for Detection of Retinal Emboli and Unmasking Undiagnosed Systemic Abnormalities. J Ophthalmic Vis Res 2016; 11:449-451. [PMID: 27994818 PMCID: PMC5139561 DOI: 10.4103/2008-322x.194149] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Bindu Rajesh
- Department of Vitreoretina, Giridhar Eye Institute, Cochin, Kerala, India
| | - Rameez Hussain
- Department of Vitreoretina, Giridhar Eye Institute, Cochin, Kerala, India
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13
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Bunaciu AA, Hoang VD, Aboul-Enein HY. Vibrational Micro-Spectroscopy of Human Tissues Analysis: Review. Crit Rev Anal Chem 2016; 47:194-203. [PMID: 27786540 DOI: 10.1080/10408347.2016.1253454] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Vibrational spectroscopy (Infrared (IR) and Raman) and, in particular, micro-spectroscopy and micro-spectroscopic imaging have been used to characterize developmental changes in tissues, to monitor these changes in cell cultures and to detect disease and drug-induced modifications. The conventional methods for biochemical and histophatological tissue characterization necessitate complex and "time-consuming" sample manipulations and the results are rarely quantifiable. The spectroscopy of molecular vibrations using mid-IR or Raman techniques has been applied to samples of human tissue. This article reviews the application of these vibrational spectroscopic techniques for analysis of biological tissue published between 2005 and 2015.
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Affiliation(s)
- Andrei A Bunaciu
- a SCIENT-Research Center for Instrumental Analysis , Tancabesti-Snagov , Romania
| | - Vu Dang Hoang
- b Department of Analytical Chemistry and Toxicology , Hanoi University of Pharmacy , Hanoi , Vietnam
| | - Hassan Y Aboul-Enein
- c Pharmaceutical and Medicinal Chemistry Department , Pharmaceutical and Drug Industries Research Division , Egypt
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14
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Abstract
Coronary artery disease is the result of atherosclerotic changes to the coronary arterial wall, comprising endothelial dysfunction, vascular inflammation and deposition of lipid-rich macrophage foam cells. Certain high-risk atherosclerotic plaques are vulnerable to disruption, leading to rupture, thrombosis and the clinical sequelae of acute coronary syndrome. Though recognised as the gold standard for evaluating the presence, distribution and severity of atherosclerotic lesions, invasive coronary angiography is incapable of identifying non-stenotic, vulnerable plaques that are responsible for adverse cardiovascular events. The recognition of such limitations has impelled the development of intracoronary imaging technologies, including intravascular ultrasound, optical coherence tomography and near-infrared spectroscopy, which enable the detailed evaluation of the coronary wall and atherosclerotic plaques in clinical practice. This review discusses the present status of invasive imaging technologies; summarises up-to-date, evidence-based clinical guidelines; and addresses questions that remain unanswered with regard to the future of intracoronary plaque imaging.
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Affiliation(s)
- Jonathan A Batty
- Institute of Cellular Medicine, Newcastle University, 3rd Floor, William Leech Building, Newcastle Upon Tyne, NE2 4HH, UK. .,Freeman Hospital, Newcastle Upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, NE7 7DN, UK.
| | - Shristy Subba
- Institute of Cellular Medicine, Newcastle University, 3rd Floor, William Leech Building, Newcastle Upon Tyne, NE2 4HH, UK.
| | - Peter Luke
- Freeman Hospital, Newcastle Upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, NE7 7DN, UK.
| | - Li Wing Chi Gigi
- Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
| | - Hannah Sinclair
- Institute of Cellular Medicine, Newcastle University, 3rd Floor, William Leech Building, Newcastle Upon Tyne, NE2 4HH, UK. .,Freeman Hospital, Newcastle Upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, NE7 7DN, UK.
| | - Vijay Kunadian
- Institute of Cellular Medicine, Newcastle University, 3rd Floor, William Leech Building, Newcastle Upon Tyne, NE2 4HH, UK. .,Freeman Hospital, Newcastle Upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, NE7 7DN, UK.
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15
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Benedek T, Maurovich-Horváth P, Ferdinandy P, Merkely B. The Use of Biomarkers for the Early Detection of Vulnerable Atherosclerotic Plaques and Vulnerable Patients. A Review. JOURNAL OF CARDIOVASCULAR EMERGENCIES 2016. [DOI: 10.1515/jce-2016-0017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Abstract
Acute coronary syndromes represent the most severe consequences of atherosclerosis, most often triggered by the rupture of a coronary plaque, which, for various reasons, has become unstable. In many cases, these rupture-prone vulnerable plaques are difficult to diagnose, because they do not always cause significant obstruction noticeable by coronary angiography. Therefore, new methods and tools for the identification of vulnerable plaques have been proposed, many of which are currently under study. Various biomarkers have been suggested as predictors of a vulnerable plaque, as well as indicators of an increased inflammatory status associated with higher patient susceptibility for plaque rupture. Integration of such biomarkers into multiple biomarker platforms has been suggested to identify superior diagnostic algorithms for the early detection of the high-risk condition associated with an unstable plaque. The aim of this review is to summarize recent research related to biomarkers used for the early detection of vulnerable plaques and vulnerable patients.
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Affiliation(s)
- Theodora Benedek
- Department of Cardiology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
| | - Pál Maurovich-Horváth
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Péter Ferdinandy
- Pharmahungary Group, Szeged, Hungary
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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16
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Calcagno C, Mulder WJM, Nahrendorf M, Fayad ZA. Systems Biology and Noninvasive Imaging of Atherosclerosis. Arterioscler Thromb Vasc Biol 2016; 36:e1-8. [PMID: 26819466 PMCID: PMC4861402 DOI: 10.1161/atvbaha.115.306350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Claudia Calcagno
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.).
| | - Willem J M Mulder
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
| | - Matthias Nahrendorf
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
| | - Zahi A Fayad
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
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17
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Czernuszewicz TJ, Homeister JW, Caughey MC, Farber MA, Fulton JJ, Ford PF, Marston WA, Vallabhaneni R, Nichols TC, Gallippi CM. Non-invasive in vivo characterization of human carotid plaques with acoustic radiation force impulse ultrasound: comparison with histology after endarterectomy. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:685-97. [PMID: 25619778 PMCID: PMC4331250 DOI: 10.1016/j.ultrasmedbio.2014.09.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 08/30/2014] [Accepted: 09/10/2014] [Indexed: 05/03/2023]
Abstract
Ischemic stroke from thromboembolic sources is linked to carotid artery atherosclerotic disease with a trend toward medical management in asymptomatic patients. Extent of disease is currently diagnosed by non-invasive imaging techniques that measure luminal stenosis, but it has been suggested that a better biomarker for determining risk of future thromboembolic events is plaque morphology and composition. Specifically, plaques that are composed of mechanically soft lipid/necrotic regions covered by thin fibrous caps are the most vulnerable to rupture. An ultrasound technique that non-invasively interrogates the mechanical properties of soft tissue, called acoustic radiation force impulse (ARFI) imaging, has been developed as a new modality for atherosclerotic plaque characterization using phantoms and atherosclerotic pigs, but the technique has yet to be validated in vivo in humans. In this preliminary study, in vivo ARFI imaging is presented in a case study format for four patients undergoing clinically indicated carotid endarterectomy and compared with histology. In two type Va plaques, characterized by lipid/necrotic cores covered by fibrous caps, mean ARFI displacements in focal regions were high relative to the surrounding plaque material, suggesting soft features were covered by stiffer layers within the plaques. In two type Vb plaques, characterized by heavy calcification, mean ARFI peak displacements were low relative to the surrounding plaque and arterial wall, suggesting stiff tissue. This pilot study illustrates the feasibility and challenges of transcutaneous ARFI for characterizing the material and structural composition of carotid atherosclerotic plaques via mechanical properties, in humans, in vivo.
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Affiliation(s)
- Tomasz J Czernuszewicz
- Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA
| | - Jonathon W Homeister
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, USA; McAllister Heart Institute, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Melissa C Caughey
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Mark A Farber
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joseph J Fulton
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Peter F Ford
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - William A Marston
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Timothy C Nichols
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Caterina M Gallippi
- McAllister Heart Institute, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Electrical and Computer Engineering, North Carolina State University, Raleigh, North Carolina, USA; Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, North Carolina, USA.
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18
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Vignali L, Solinas E, Emanuele E. Research and clinical applications of optical coherence tomography in invasive cardiology: a review. Curr Cardiol Rev 2014; 10:369-76. [PMID: 24893934 PMCID: PMC4101202 DOI: 10.2174/1573403x10666140604120753] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 05/29/2014] [Accepted: 06/01/2014] [Indexed: 11/22/2022] Open
Abstract
In cardiology, optical coherence tomography (OCT) is an invasive imaging technique based on the principle of light coherence. This system was developed to obtain three-dimensional high resolution images to examine coronary artery normal and/or pathological structure. This technique replaces the ultrasound used by its main alternative procedure, intravascular ultrasound, by a near-infrared light source. Acute coronary syndromes due to atherosclerotic vascular disease are the leading cause of mortality in developed and developing countries. As a consequence, intravascular imaging systems became an important area of research and 1991 marks the first use of OCT in coronary artery observations. Since its first appearance in invasive cardiology, OCT maintains a strong presence in the research environments for the identification of vulnerable plaques, as it is able to overcome difficulties presented by other techniques such as virtual intravascular ultrasound, near-infrared spectroscopy, and histology. Moreover, OCT is increasingly being used in the clinical practice as a guide during coronary interventions and in the assessment of vascular response after coronary stent implantation. This review focuses on the relevance of OCT in research and clinical applications in the field of invasive cardiology and discusses the future directions of the field.
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Affiliation(s)
| | | | - Enzo Emanuele
- Living Research s.a.s., Via Monte Grappa, 13, I-27038, Robbio (PV), Italy.
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19
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Serdoz R, Pighi M, Konstantinidis NV, Kilic ID, Abou-Sherif S, Di Mario C. Thrombus Aspiration in Primary Angioplasty for ST-segment Elevation Myocardial Infarction. Curr Atheroscler Rep 2014; 16:431. [DOI: 10.1007/s11883-014-0431-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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