Abstract
Objectives: To evaluate the feasibility of noninvasive assessment of the characteristics of disrupted atherosclerotic plaques, the authors interrogated the culprit lesions in acute coronary syndromes (ACS) by multislice computed tomography (CT). Background: Disrupted atherosclerotic plaques responsible for ACS histopathologically demonstrate large lipid cores and positive vascular remodeling. It is expected that plaques vulnerable to rupture should bear similar imaging signatures by CT. Methods: Either 0.5-mm × 16-slice or 64-slice CT was performed in 38 patients with ACS and compared with 33 patients with stable angina pectoris (SAP) before percutaneous coronary intervention. The coronary plaques in ACS and SAP were evaluated for the CT plaque characteristics, including vessel remodeling, consistency of noncalcified plaque (NCP <30 HU or 30 HU <NCP <150 HU), and spotty or large calcification. Results: In the CT profile of culprit ACS and SAP lesions, the frequency of 30 HU <NCP <150 HU (100% vs. 100%, p = NS) was not different, and large calcification (22% vs. 55%, p = 0.004) was significantly more frequent in the stable lesions. Positive remodeling (87% vs. 12%, p < 0.0001), NCP <30 HU (79% vs. 9%, p < 0.0001), and spotty calcification (63% vs. 21%, p = 0.0005) were significantly more frequent in the ACS lesions. Presence of all 3 (i.e., positive remodeling, NCP <30 HU, and spotty calcification) showed a high positive predictive value, and absence of all 3 showed a high negative predictive value for the culprit plaques associated with ACS. Conclusions: The CT characteristics of plaques associated with ACS include positive vascular remodeling, low plaque density, and spotty calcification. It is logical to presume that plaques vulnerable to rupture harbor similar characteristics.
| Original language | English |
|---|---|
| Pages (from-to) | 319-326 |
| Number of pages | 8 |
| Journal | Journal of the American College of Cardiology |
| Volume | 50 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 24-07-2007 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Multislice Computed Tomographic Characteristics of Coronary Lesions in Acute Coronary Syndromes. / Motoyama, Sadako; Kondo, Takeshi; Sarai, Masayoshi; Sugiura, Atsushi; Harigaya, Hiroto; Sato, Takahisa; Inoue, Kaori; Okumura, Masanori; Ishii, Junichi; Anno, Hirofumi; Virmani, Renu; Ozaki, Yukio; Hishida, Hitoshi; Narula, Jagat.
In: Journal of the American College of Cardiology, Vol. 50, No. 4, 24.07.2007, p. 319-326.Research output: Contribution to journal › Article
TY - JOUR
T1 - Multislice Computed Tomographic Characteristics of Coronary Lesions in Acute Coronary Syndromes
AU - Motoyama, Sadako
AU - Kondo, Takeshi
AU - Sarai, Masayoshi
AU - Sugiura, Atsushi
AU - Harigaya, Hiroto
AU - Sato, Takahisa
AU - Inoue, Kaori
AU - Okumura, Masanori
AU - Ishii, Junichi
AU - Anno, Hirofumi
AU - Virmani, Renu
AU - Ozaki, Yukio
AU - Hishida, Hitoshi
AU - Narula, Jagat
PY - 2007/7/24
Y1 - 2007/7/24
N2 - Objectives: To evaluate the feasibility of noninvasive assessment of the characteristics of disrupted atherosclerotic plaques, the authors interrogated the culprit lesions in acute coronary syndromes (ACS) by multislice computed tomography (CT). Background: Disrupted atherosclerotic plaques responsible for ACS histopathologically demonstrate large lipid cores and positive vascular remodeling. It is expected that plaques vulnerable to rupture should bear similar imaging signatures by CT. Methods: Either 0.5-mm × 16-slice or 64-slice CT was performed in 38 patients with ACS and compared with 33 patients with stable angina pectoris (SAP) before percutaneous coronary intervention. The coronary plaques in ACS and SAP were evaluated for the CT plaque characteristics, including vessel remodeling, consistency of noncalcified plaque (NCP <30 HU or 30 HU <NCP <150 HU), and spotty or large calcification. Results: In the CT profile of culprit ACS and SAP lesions, the frequency of 30 HU <NCP <150 HU (100% vs. 100%, p = NS) was not different, and large calcification (22% vs. 55%, p = 0.004) was significantly more frequent in the stable lesions. Positive remodeling (87% vs. 12%, p < 0.0001), NCP <30 HU (79% vs. 9%, p < 0.0001), and spotty calcification (63% vs. 21%, p = 0.0005) were significantly more frequent in the ACS lesions. Presence of all 3 (i.e., positive remodeling, NCP <30 HU, and spotty calcification) showed a high positive predictive value, and absence of all 3 showed a high negative predictive value for the culprit plaques associated with ACS. Conclusions: The CT characteristics of plaques associated with ACS include positive vascular remodeling, low plaque density, and spotty calcification. It is logical to presume that plaques vulnerable to rupture harbor similar characteristics.
AB - Objectives: To evaluate the feasibility of noninvasive assessment of the characteristics of disrupted atherosclerotic plaques, the authors interrogated the culprit lesions in acute coronary syndromes (ACS) by multislice computed tomography (CT). Background: Disrupted atherosclerotic plaques responsible for ACS histopathologically demonstrate large lipid cores and positive vascular remodeling. It is expected that plaques vulnerable to rupture should bear similar imaging signatures by CT. Methods: Either 0.5-mm × 16-slice or 64-slice CT was performed in 38 patients with ACS and compared with 33 patients with stable angina pectoris (SAP) before percutaneous coronary intervention. The coronary plaques in ACS and SAP were evaluated for the CT plaque characteristics, including vessel remodeling, consistency of noncalcified plaque (NCP <30 HU or 30 HU <NCP <150 HU), and spotty or large calcification. Results: In the CT profile of culprit ACS and SAP lesions, the frequency of 30 HU <NCP <150 HU (100% vs. 100%, p = NS) was not different, and large calcification (22% vs. 55%, p = 0.004) was significantly more frequent in the stable lesions. Positive remodeling (87% vs. 12%, p < 0.0001), NCP <30 HU (79% vs. 9%, p < 0.0001), and spotty calcification (63% vs. 21%, p = 0.0005) were significantly more frequent in the ACS lesions. Presence of all 3 (i.e., positive remodeling, NCP <30 HU, and spotty calcification) showed a high positive predictive value, and absence of all 3 showed a high negative predictive value for the culprit plaques associated with ACS. Conclusions: The CT characteristics of plaques associated with ACS include positive vascular remodeling, low plaque density, and spotty calcification. It is logical to presume that plaques vulnerable to rupture harbor similar characteristics.
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U2 - 10.1016/j.jacc.2007.03.044
DO - 10.1016/j.jacc.2007.03.044
M3 - Article
VL - 50
SP - 319
EP - 326
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 4
ER -