Abstract
Tissue characterization plays an important role in the development of acute coronary syndromes. iMap is an intravascular ultrasound (IVUS) tissue characterization system that provides useful information by reconstructing color-coded maps. Mechanical properties due to dynamic mechanical stress during a cardiac cycle may also trigger vulnerable plaque. Speckle tracking IVUS (ST-IVUS) has been introduced to observe plaque behavior in relation to mechanical properties. We report the case of an 84-year-old woman with stable coronary artery disease who underwent percutaneous coronary intervention, at which time IVUS demonstrated mainly three low echoic areas like lipid pools with thick fibrous caps. Pathological evaluation with iMap revealed that one low echoic area was occupied with necrotic tissue and that the other two areas occupied fibrotic. Although those tissue characterizations were different, they showed similar stretching behavior at systole by ST-IVUS which depicted plaque behavior from IVUS images using a color mapping. The mechanical properties of individual coronary plaques may differ depending on the tissue disposition. It is necessary to consider mechanical properties using ST-IVUS as well as to evaluate tissue characterization in plaque risk stratification.
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We would like to thank Mr. Sato N and Ms. Nagaya M for supporting experimental equipment.
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ST had the overall responsibility and was accountable for the entire process. MK and TN contributed to the conception of this manuscript and were responsible for the overall IVUS analysis. TS was responsible for the entire procedure during PCI. NT and TF contributed to the PCI procedure and to the acquisition of IVUS data. MI, HY, and TK contributed to the measurement of ST-IVUS. TK contributed to the measurement of iMap. SW, TM, SM, and HO provided support for the conception of this manuscript. The first draft of the manuscript was written by ST and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This case study was conducted according to 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 Ministry of Education, Culture, Sports, Science, and Technology of Japan. This case study was approved by the Ethics Committee of Asahi University Hospital (approval number: 2018-10-06).
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Tanaka, S., Kawasaki, M., Noda, T. et al. Observation of plaque behavior and tissue characterization of coronary plaque using speckle tracking intravascular ultrasound (ST-IVUS) and iMap imaging system. Heart Vessels 38, 131–135 (2023). https://doi.org/10.1007/s00380-022-02056-5
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DOI: https://doi.org/10.1007/s00380-022-02056-5