Improved criteria for the recognition of atherosclerotic plaque using fluorescence spectroscopy
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To determine the fluorescence pattern for distinguishing normal (N) from calcified and fibrous plaque (P), fluorescence spectra of cadaveric aorta were measured with a spectrofluorometer. Emission (Em) and excitation (Ex) spectra corrected for instrumental response were obtained from 200 to 1000 nm. Specimens from 50 patients were measured less than 24 h after autopsy and then examined histologically. Spectra from 25 specimens demonstrated that the ratio of fluorescence intensity 460 nm/385 nm with Ex=337 nm provided separation of N from P (1.53±29 vs 0.82±0.25,p<0.01) and that a ratio of 1.25 correctly identified all N and P. A prospective test of this ratio on an additional 25 specimens yielded a significant difference between N and P (1.70±0.37 vs 0.87±0.23,p<0.0001) with a value of 1.25 correctly identifying all (10/10) N and 93% (14/15) P. Prospective analysis of previously proposed fluorescence ratios (600 nm/580 nm at Ex=480 nm; 530 nm/550 nm at Ex=459 nm; 448 nm/514 nm and 538 nm/514 nm at Ex=337 nm) all resulted in poor separation of N from P. The ratio of 460 nm/385 nm with Ex=337 nm is superior to previously reported criteria for distinguishing N from P and may be useful for guiding laser angioplasty systems.
Key wordsLaser angioplasty Coronary artery disease Nitrogen laser Tissue fluorescence
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