Molecular Imaging of Native Low-Density Lipoprotein by Near-Infrared Fluorescent Angioscopy in Human Coronary Plaques
Yasumi Uchida1, Tomoe Yoshida2, Ei Shimoyama3
1The Institute of Japanese Foundation for Cardiovascular Research, Funabashi, Japan.
Insights
Low-density lipoprotein (LDL) accumulates in early atherosclerosis, peaking in white plaques and decreasing in mature yellow plaques. Early intervention targeting LDL is crucial before plaque maturation.
Area of Science:
- Cardiovascular Medicine
- Biomedical Imaging
- Atherosclerosis Research
Background:
- Low-density lipoprotein (LDL) is a key risk factor for coronary artery disease.
- The precise localization of LDL within the human coronary arterial wall remains unclear.
Purpose of the Study:
- To investigate the in vivo and ex vivo localization of LDL within human coronary arterial walls.
- To understand LDL deposition patterns during different stages of atherosclerotic plaque development.
Main Methods:
- Utilized a near-infrared fluorescent angioscopy system with indocyanine green dye as an LDL biomarker.
- Analyzed LDL incidence in normal arterial segments, white plaques (early stage), and yellow plaques (mature stage) from autopsy and in vivo studies.
Main Results:
- LDL incidence was significantly higher in white plaques (79.1%) compared to normal segments (14.2%) and yellow plaques (28.5%).
- LDL deposition increases with plaque growth and decreases in mature plaque stages.
- In vivo results corroborated ex vivo findings.
Conclusions:
- LDL begins to deposit in the coronary arterial wall during the early stages of atherosclerosis.
- Targeted molecular therapy for LDL should be initiated before plaque maturation for maximum efficacy.
Abstract:
Low-density lipoprotein (LDL) is an important risk factor for coronary artery disease, but its localization within the human coronary arterial wall is poorly understood. Imaging of LDL in 30 coronary arteries excised from 15 subjects who underwent autopsy was performed using near-infrared fluorescent angioscopy system and using indocyanine green dye as a biomarker of LDL. The percentage incidence of LDL in 28 normal segments, 24 white plaques (early stage of plaque growth), and 21 yellow plaques (mature stage of plaque) classified by conventional angioscopy, was 14.2, 79.1 (p <0.01 vs normal segments and p <0.05 vs yellow plaques), and 28.5, respectively. Coronary near-infrared fluorescent angioscopy showed similar results in 7 patients in vivo. Our results suggested that LDL begins to deposit in the human coronary arterial wall in the early stage of atherosclerosis, increasingly deposits with plaque growth and decreases in the mature stage; and therefore, molecular therapy targeting LDL should be started before plaque maturation.
