The combination of two imaging technologies can better identify dangerous coronary plaques ;
Combing optical coherence tomography (OCT) with other advanced imaging technology can identify more accurately the plates coronary arteries are more likely to rupture and cause a heart attack. In a report that appears online in JACC Cardiovascular Imaging , researchers at the Wellman Center for Photomedicine at Massachusetts General Hospital (MGH) describe the first use in patients with a catheter-based device that uses both OCT and near infrared autofluorescence (NIRAF) imaging.
“TCO offers Images microstructure of the tissue, but not its chemical and molecular composition,” says Gary Tearney, MD, PhD, of the Wellman Center and the Department of MGH pathology, co-author of the paper. “They Since both of these features are necessary to fully understand coronary artery disease , the combination of the OCT with NIRAF could provide a powerful tool for the investigation of coronary disease.”
Detailed images provided by OCT are created by the rebound from the near-infrared light from the inner surfaces of blood vessels and can identify the plates having the appearance of “vulnerable” plaques tend to rupture with the potential to cause a heart attack or sudden cardiac death. Imaging techniques such as fluorescence light NIRAF an artery with a specific wavelength of light to excite certain molecules, which respond by issuing different wavelengths. Since only certain molecules respond, the resulting signal provides information on the molecular composition of the analyzed tissue.
team Tearney has been investigating whether the additional data provided by NIRAF could identify sites prone rupture arterial plaques – particularly atheromas, advanced lesions consist of a core covered dead cells by a fibrous layer thin often which they are particularly prone to rupture. In a previous study using coronary artery segments of corpses, the researchers showed that the signal NIRAF was raised in fibroatheromas and highest in those with a thin fibrous cap. This study is the first to investigate the use of NIRAF in living patients.
The study involved 12 patients who received cardiac catheterization at MGH between July 2014 and January 2015. In addition to clinical procedures performed to diagnose and / or treat heart disease patients, Farouc Jaffer, MD, PhD, director of the MGH coronary intervention and co-lead author of the article, used the new device developed by the team at Wellman / MGH that acquires data and OCT NIRAF to construct images of coronary arterial segments. The investigation procedure was identical to that used for conventional images October.
“Making images OCT-NIRAF is like the embodiment of PTU independent coronary images, and are now able to obtain fluorescence in the near infrared plate biological information seamlessly integrated with OCT anatomical images, with no time additional required, “says Jaffer. “The clinical success of OCT-NIRAF should further pave way forward for the specific molecular imaging fluorescence in the near infrared using injectable or molecularly specific cellular agents.”
The main results of the study were the confirmation that the procedure was as safe as conventional feasible and October. OCT images-NIRAF revealed that NIRAF signal was high in areas where the results of the OCT suggested the presence of a fibro, and even higher in lesions with thin covers or sites of plaque rupture and clot formation. Several aspects of signal NIRAF were different from the patterns produced by other forms of coronary vascular imaging, and more research is needed to determine the molecular basis and clinical significance of the results of NIRAF signal. NIRAF was also high on sites that show evidence of inflammation, another potential biomarker likely to break the plates.
“Overall, we believe the OCT-NIRAF examination combined provides information on the molecules in arterial plaques and other characteristics associated with an increased risk of an acute coronary event,” says Tearney, professor of pathology at the School of Harvard medical Dangers and Mike and Sue MGH Family Research Scholar. “But right now it is a hypothesis, and our findings need to be confirmed in larger studies, which we intend to be launched later this year.”
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Posted in: Cardiology