Intracoronary Structural-Molecular Imaging for Multitargeted Characterization of High-Risk Plaque: First-in-Human
Sunwon Kim1,2, Hyeong Soo Nam3, Dong Oh Kang1
1Multimodal Imaging and Theranostic Lab, Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea.
Optical coherence tomography-fluorescence lifetime imaging (OCT-FLIm) is a safe and feasible intracoronary imaging technique for characterizing coronary artery disease plaques. This dual-modal approach provides microstructural and molecular insights, aiding in the diagnosis of high-risk plaques.
Area of Science:
- Cardiovascular Imaging
- Biomedical Optics
- Atherosclerosis Research
Background:
- Fluorescence lifetime imaging (FLIm) visualizes atherosclerosis biochemistry.
- Optical coherence tomography (OCT)-FLIm offers dual microstructural and compositional plaque information.
- Clinical validation of intracoronary OCT-FLIm is needed.
Purpose of the Study:
- Assess the clinical feasibility and safety of OCT-FLIm for characterizing coronary plaque composition.
- Investigate OCT-FLIm's utility in patients with coronary artery disease (CAD) undergoing revascularization.
Main Methods:
- Prospective, single-center diagnostic feasibility study of 40 CAD patients.
- Utilized a novel intracoronary OCT-FLIm system with 2.6-F catheters.
- Compared OCT-FLIm findings with intravascular ultrasound and autopsy study correlations.
Main Results:
- OCT-FLIm successfully characterized plaque molecular signatures (macrophages, fibrosis, etc.) reproducibly.
- Higher plaque inflammation detected in acute coronary syndrome (ACS) vs. chronic stable angina (CSA) patients (P < .001).
- Healed plaque phenotype more prevalent in rapidly progressing lesions (P < .001).
Conclusions:
- Intracoronary OCT-FLIm is clinically feasible and safe for comprehensive atheroma characterization.
- Supports OCT-FLIm's potential role in diagnosing and understanding high-risk plaques.
- Dual-modal imaging enhances diagnostic capabilities for cardiovascular disease.
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