Thin cap fibroatheroma defined as lipid core abutting lumen (LCAL) on integrated backscatter intravascular ultrasound: Comparison with optical coherence tomography and correlation with peri-procedural myocardial infarction

Yukio Ozaki, Masaya Ohota, Tevfik F. Ismail, Masanori Okumura, Masato Ishikawa, Takashi Muramatsu

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: This study evaluated the ability of a newly developed integrated backscatter intravascular ultrasound (IB-IVUS) system (VISIWAVE, Terumo, Tokyo, Japan) to detect optical coherence tomography (OCT)-verified thin cap fibroatheroma (TCFA) and assessed the correlation with peri-procedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). Methods and Results: One hundred culprit lesions in 100 consecutive patients with ischemic heart disease who consented to repeated IVUS and OCT prior to PCI were studied. Of 100 lesions, 48 had OCT-verified TCFA with a cap thickness <65 μm. Such lesions had larger percentage lipid area and lipid angle >2 quadrants on IB-IVUS. A lipid core abutting lumen (LCAL) was defined as a lipid core pool in the plaque area, directly contacting with the lumen regardless of its circumferential extension. IB-IVUS-identified TCFA defined as a combination of percentage lipid area ≥53.6%, remodeling index ≥1.03, and the presence of LCAL was the best predictor of OCT-verified TCFA with sensitivity, specificity, positive and negative predictive values, and accuracy of 72.9%, 90.4%, 87.5%, 78.3%, and 82.0%, respectively. IB-IVUS-identified TCFA as well as OCT-verified TCFA were significant independent predictors of PMI, after adjusting for other predictors on multivariate analysis. Conclusions: IB-IVUS can be used to identify plaques with a high prevalence of TCFA. Such techniques can therefore potentially be used to identify lesions with an elevated risk of PMI after PCI.

Original languageEnglish
Pages (from-to)808-817
Number of pages10
JournalCirculation Journal
Volume79
Issue number4
DOIs
Publication statusPublished - 01-01-2015

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Optical Coherence Tomography
Atherosclerotic Plaques
Myocardial Infarction
Lipids
Percutaneous Coronary Intervention
Tokyo
Myocardial Ischemia
Japan
Multivariate Analysis
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{013240b3e1f142b5bf24d20a61786997,
title = "Thin cap fibroatheroma defined as lipid core abutting lumen (LCAL) on integrated backscatter intravascular ultrasound: Comparison with optical coherence tomography and correlation with peri-procedural myocardial infarction",
abstract = "Background: This study evaluated the ability of a newly developed integrated backscatter intravascular ultrasound (IB-IVUS) system (VISIWAVE, Terumo, Tokyo, Japan) to detect optical coherence tomography (OCT)-verified thin cap fibroatheroma (TCFA) and assessed the correlation with peri-procedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). Methods and Results: One hundred culprit lesions in 100 consecutive patients with ischemic heart disease who consented to repeated IVUS and OCT prior to PCI were studied. Of 100 lesions, 48 had OCT-verified TCFA with a cap thickness <65 μm. Such lesions had larger percentage lipid area and lipid angle >2 quadrants on IB-IVUS. A lipid core abutting lumen (LCAL) was defined as a lipid core pool in the plaque area, directly contacting with the lumen regardless of its circumferential extension. IB-IVUS-identified TCFA defined as a combination of percentage lipid area ≥53.6{\%}, remodeling index ≥1.03, and the presence of LCAL was the best predictor of OCT-verified TCFA with sensitivity, specificity, positive and negative predictive values, and accuracy of 72.9{\%}, 90.4{\%}, 87.5{\%}, 78.3{\%}, and 82.0{\%}, respectively. IB-IVUS-identified TCFA as well as OCT-verified TCFA were significant independent predictors of PMI, after adjusting for other predictors on multivariate analysis. Conclusions: IB-IVUS can be used to identify plaques with a high prevalence of TCFA. Such techniques can therefore potentially be used to identify lesions with an elevated risk of PMI after PCI.",
author = "Yukio Ozaki and Masaya Ohota and Ismail, {Tevfik F.} and Masanori Okumura and Masato Ishikawa and Takashi Muramatsu",
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Thin cap fibroatheroma defined as lipid core abutting lumen (LCAL) on integrated backscatter intravascular ultrasound : Comparison with optical coherence tomography and correlation with peri-procedural myocardial infarction. / Ozaki, Yukio; Ohota, Masaya; Ismail, Tevfik F.; Okumura, Masanori; Ishikawa, Masato; Muramatsu, Takashi.

In: Circulation Journal, Vol. 79, No. 4, 01.01.2015, p. 808-817.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Thin cap fibroatheroma defined as lipid core abutting lumen (LCAL) on integrated backscatter intravascular ultrasound

T2 - Comparison with optical coherence tomography and correlation with peri-procedural myocardial infarction

AU - Ozaki, Yukio

AU - Ohota, Masaya

AU - Ismail, Tevfik F.

AU - Okumura, Masanori

AU - Ishikawa, Masato

AU - Muramatsu, Takashi

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: This study evaluated the ability of a newly developed integrated backscatter intravascular ultrasound (IB-IVUS) system (VISIWAVE, Terumo, Tokyo, Japan) to detect optical coherence tomography (OCT)-verified thin cap fibroatheroma (TCFA) and assessed the correlation with peri-procedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). Methods and Results: One hundred culprit lesions in 100 consecutive patients with ischemic heart disease who consented to repeated IVUS and OCT prior to PCI were studied. Of 100 lesions, 48 had OCT-verified TCFA with a cap thickness <65 μm. Such lesions had larger percentage lipid area and lipid angle >2 quadrants on IB-IVUS. A lipid core abutting lumen (LCAL) was defined as a lipid core pool in the plaque area, directly contacting with the lumen regardless of its circumferential extension. IB-IVUS-identified TCFA defined as a combination of percentage lipid area ≥53.6%, remodeling index ≥1.03, and the presence of LCAL was the best predictor of OCT-verified TCFA with sensitivity, specificity, positive and negative predictive values, and accuracy of 72.9%, 90.4%, 87.5%, 78.3%, and 82.0%, respectively. IB-IVUS-identified TCFA as well as OCT-verified TCFA were significant independent predictors of PMI, after adjusting for other predictors on multivariate analysis. Conclusions: IB-IVUS can be used to identify plaques with a high prevalence of TCFA. Such techniques can therefore potentially be used to identify lesions with an elevated risk of PMI after PCI.

AB - Background: This study evaluated the ability of a newly developed integrated backscatter intravascular ultrasound (IB-IVUS) system (VISIWAVE, Terumo, Tokyo, Japan) to detect optical coherence tomography (OCT)-verified thin cap fibroatheroma (TCFA) and assessed the correlation with peri-procedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). Methods and Results: One hundred culprit lesions in 100 consecutive patients with ischemic heart disease who consented to repeated IVUS and OCT prior to PCI were studied. Of 100 lesions, 48 had OCT-verified TCFA with a cap thickness <65 μm. Such lesions had larger percentage lipid area and lipid angle >2 quadrants on IB-IVUS. A lipid core abutting lumen (LCAL) was defined as a lipid core pool in the plaque area, directly contacting with the lumen regardless of its circumferential extension. IB-IVUS-identified TCFA defined as a combination of percentage lipid area ≥53.6%, remodeling index ≥1.03, and the presence of LCAL was the best predictor of OCT-verified TCFA with sensitivity, specificity, positive and negative predictive values, and accuracy of 72.9%, 90.4%, 87.5%, 78.3%, and 82.0%, respectively. IB-IVUS-identified TCFA as well as OCT-verified TCFA were significant independent predictors of PMI, after adjusting for other predictors on multivariate analysis. Conclusions: IB-IVUS can be used to identify plaques with a high prevalence of TCFA. Such techniques can therefore potentially be used to identify lesions with an elevated risk of PMI after PCI.

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U2 - 10.1253/circj.CJ-14-0758

DO - 10.1253/circj.CJ-14-0758

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