European Heart Journal Advance Access originally published online on May 5, 2007
European Heart Journal 2007 28(14):1784; doi:10.1093/eurheartj/ehm146
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Coronary plaque composition of culprit/target lesions according to the clinical presentation: a virtual histology intravascular ultrasound analysis
Cardiology and Catheterization Laboratories
Shonan Kamakura General Hospital
1202-1 Yamazaki
Kamakura 247-8533
Japan
Tel: +81 467 46 1717 Fax: +81 467 46 1907 E-mail address: kaneda{at}kamakuraheart.org
With great interest I read the article by Surmely et al.1 comparing plaque composition of patients with acute coronary syndrome (ACS) and stable angina pectoris (AP) using virtual histology intravascular ultrasound (VH-IVUS). The authors reported that ‘At the minimal lumen site, ... necrotic core and dense calcium plaque area were smaller in ACS lesions (Necrotic core: 6.8 ± 6.0 vs. 11.0 ± 8.3%, P = 0.02; Dense calcium: 2.6 ± 3.0 vs. 4.9 ± 5.8%, P = 0.03).’ However, the authors previously reported that ‘the frequency of necrotic core was significantly higher in the ACS group than in the stable AP group (in vitro histopathology: 22.6% vs. 12.6%, p = 0.02; in vivo virtual histology: 24.5% vs. 10.4%, p = 0.002)’ in another study.2 Given both studies conducted were of similar design and from the same institute, the patient/lesion characteristics seem similar. Potential explanations for the contradictions include the difference of the IVUS system used; a 30 MHz mechanically rotating catheter (Boston Scientific Scimed Inc., Maple Grove, MN, USA) in the previous study and a 20 MHz phased-array IVUS catheter (Eagle Eye, Volcano therapeutics, Rancho Cordova, CA, USA) in this study. Previous studies with grey-scale IVUS imaging have suggested that there is a significant difference in image representation among the IVUS systems studied in the diagnosis of tissue components of complex atherosclerotic plaque.3,4 Therefore, it would be of great help if the authors would provide VH-IVUS data comparing these two IVUS systems in same patient/lesion.
References
- Surmely JF, Nasu K, Fujita H, Terashima M, Matsubara T, Tsuchikane E, Ehara M, Kinoshita Y, Zheng QX, Tanaka N, Katoh O, Suzuki T. Coronary plaque composition of culprit/target lesions according to the clinical presentation: a virtual histology intravascular ultrasound analysis. Eur Heart J (2006) 27:2939–2944.
[Abstract/Free Full Text] - Nasu K, Tsuchikane E, Katoh O, Vince DG, Virmani R, Surmely JF, Murata A, Takeda Y, Ito T, Ehara M, Matsubara T, Terashima M, Suzuki T. Accuracy of in vivo coronary plaque morphology assessment: a validation study of in vivo virtual histology compared with in vitro histopathology. J Am Coll Cardiol (2006) 47:2405–2412.
[Abstract/Free Full Text] - Hiro T, Leung CY, Russo RJ, Moussa I, Karimi H, Farvid AR, Tobis JM. Variability in tissue characterization of atherosclerotic plaque by intravascular ultrasound: a comparison of four intravascular ultrasound systems. Am J Card Imaging (1996) 10:209–218.[Medline]
- Hiro T, Leung CY, Russo RJ, Karimi H, Farvid AR, Tobis JM. Variability of a three-layered appearance in intravascular ultrasound coronary images: a comparison of morphometric measurements with four intravascular ultrasound systems. Am J Card Imaging (1996) 10:219–227.[Medline]
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