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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
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Differences determined by optical coherence tomography volumetric analysis in non-culprit lesion morphology and

Micheli Zanotti Galon1, Zhao Wang, Hiram G Bezerra

  • 1Heart Institute - InCor, São Paulo University Medical School, São Paulo, Brazil.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|September 3, 2014
PubMed

Insights

This study reveals that patients with ST-elevation myocardial infarction (STEMI) have thinner fibrous cap (FC) thickness and larger thin-cap fibroatheroma (TCFA) areas with increased inflammation in non-culprit lesions compared to stable angina pectoris (SAP) patients.

Area of Science:

  • Cardiovascular Imaging
  • Biomedical Engineering
  • Pathology

Background:

  • Current methods for fibrous cap (FC) thickness measurement in lipid plaques are manual, leading to variability and inaccuracy.
  • These methods overlook the three-dimensional (3-D) morphology of coronary artery disease.

Purpose of the Study:

  • To compare volumetric FC quantification and macrophage detection using optical coherence tomography (OCT) in non-culprit lesions of STEMI and SAP patients.
  • To assess both visual and automated image processing for macrophage detection.

Main Methods:

  • Lipid plaques from 67 patients were analyzed using OCT.
  • FC was manually delineated and automatically categorized by thickness (thin-cap fibroatheroma [TCFA] <65 μm, 65-150 μm, >150 μm).
  • Automated detection and quantification of macrophages within the segmented FC were performed.

Main Results:

  • STEMI patients exhibited significantly larger absolute categorical surface area for TCFA (0.43±0.45 mm² vs. 0.15±0.25 mm²; P=0.011) compared to SAP patients.
  • Minimum FC thickness was significantly thinner in STEMI patients (31.63±17.09 µm vs. 47.27±26.56 µm; P=0.012).
  • STEMI patients showed a greater fractional luminal area for TCFA (1.65±1.56% vs. 0.74±1.2%; P=0.046) and a higher macrophage index (0.0217±0.0081% vs. 0.0153±0.0045%; P<0.01).

Conclusions:

  • Novel OCT-based 3-D quantification reveals thinner FC and larger TCFA areas in non-culprit lesions of STEMI patients.
  • Increased inflammation, indicated by a higher macrophage index, is associated with these findings in STEMI.
  • These results highlight significant differences in plaque morphology and inflammation between STEMI and SAP patients.
Abstract

Keywords:
ST-segment elevation myocardial infarctionatherosclerosisfibrous capmacrophageoptical coherence tomographystable anginathin-cap fibroatheroma

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