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Relationship between tissue characteristics and mechanical properties of coronary plaques: a comparison between integrated backscatter intravascular ultrasound (IVUS) and speckle-tracking IVUS

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Abstract

High-risk coronary plaques have certain morphological characteristics. Thus, comprehensive assessment is needed for the risk stratification of plaques in patients with coronary artery disease. Integrated backscatter intravascular ultrasound (IB-IVUS) has been used successfully used to evaluate the tissue characteristics of coronary plaques; however, the mechanical properties of plaques have been rarely assessed. Therefore, we developed Speckle-tracking IVUS (ST-IVUS) to evaluate the mechanical properties of coronary plaque. This study aimed to evaluate the relation between the tissue characteristics of coronary plaques using IB-IVUS and their mechanical properties using ST-IVUS. We evaluated 95 non-targeted plaques in 95 patients undergoing elective percutaneous coronary intervention to the left anterior descending artery. We set regions of interest (ROIs) in the cross-sectional images of coronary plaques where we divided 120 degree plaques into four quadrants (every 30 degrees), with the center at the area of maximum atheroma thickness. We measured relative calcification area (%CA, relative fibrous area (%FI) and relative lipid pool area (%LP) in a total of 380 ROIs. In ST-IVUS analysis, we measured strain in the circumferential direction of the lumen area (LA strain: %), the external elastic membrane area strain (EEM strain: %), and strain in the radial direction (radial strain: %). On global cross-sectional area IB-IVUS analysis, the %CA was 1.2 ± 1.2%; the %FI was 49.0 ± 15.9%, and the %LP was 49.7 ± 16.5%. In ST-IVUS analysis, the LA strain was 0.67 ± 0.43%; the EEM strain was 0.49 ± 0.33%, and the radial strain was 2.02 ± 1.66%. On regional analysis, the %LP was not associated with the LA strain (r = − 0.002 p = 0.97), the EEM strain (r = − 0.05 p = 0.35), or with the radial strain (r = − 0.04 p = 0.45). These trends were seen between the %FI and the LA strain (r = 0.02 p = 0.74), the %FI and the EEM strain (r = 0.05 p = 0.35), and the %FI and the radial strain (r = 0.04 p = 0.50). A significant correlation was only observed between the %CA and the LA strain (r = − 0.15 p = 0.0038). Our findings indicate that the associations between mechanical properties and tissue characteristics lacked statistical significance, more often than not, and that it is necessary to evaluate the mechanical properties as well as plaque characteristics for risk stratification of coronary plaques.

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Acknowledgements

We also would like to thank Mr. Onishi T, Ms. Nagaya M and Mr. Sato N for supporting experimental equipment and for assistance in preparing the manuscript.

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Authors and Affiliations

  1. The Department of Cardiology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan

    Shinichiro Tanaka, Tomonori Segawa & Takahiro Fuseya

  2. Gifu Heart Center, Gifu, Japan

    Masanori Kawasaki

  3. Gifu Prefectural General Medical Center, Gifu, Japan

    Toshiyuki Noda, Makoto Iwama, Hiroto Yagasaki, Takahiro Ueno, Takashi Yoshizane, Takashi Kato & Sachiro Watanabe

  4. Gifu Cardiovascular Institution, Gifu, Japan

    Taro Minagawa

  5. Gifu Municipal Hospital, Gifu, Japan

    Shinya Minatoguchi

  6. Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan

    Hiroyuki Okura

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  1. Shinichiro Tanaka
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  2. Masanori Kawasaki
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by ST, MK and TN. The first draft of the manuscript was written by ST and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript. All the authors read and approved the final manuscript.

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Correspondence to Shinichiro Tanaka.

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This study was conducted in accordance with the principles of the Declaration of Helsinki and the Ethical Guidelines for Medical and Health Research Involving Human Subjects by the Ministry of Health, Labor, and Welfare and the Ministry of Education, Culture, Sports, Science, and Technology of Japan. This study was approved by the Ethics Committee of Gifu Prefectural General Medical Center (approval number: 137).

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Tanaka, S., Kawasaki, M., Noda, T. et al. Relationship between tissue characteristics and mechanical properties of coronary plaques: a comparison between integrated backscatter intravascular ultrasound (IVUS) and speckle-tracking IVUS. Heart Vessels 38, 18–31 (2023). https://doi.org/10.1007/s00380-022-02129-5

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