Feasibility of a novel radiofrequency signal analysis for in-vivo plaque characterization in humans: comparison of plaque components between patients with and without acute coronary syndrome

Int J Cardiol. 2013 Aug 20;167(4):1591-6. doi: 10.1016/j.ijcard.2012.04.102. Epub 2012 May 10.

Abstract

Background: The iMAP™ is a novel intravascular ultrasound (IVUS)-based technology to classify coronary plaque into 4 components. The aim of this study was to evaluate the feasibility of iMAP™ technology by comparing plaque characteristics in patients with and without acute coronary syndrome (ACS and non-ACS).

Materials and methods: A total of 93 culprit lesions from 87 patients were analyzed using the iMAP™. Each plaque was classified into 4 components with a newly introduced parameter, confidence level (CL).

Results: iMAP™ analysis of the minimal lumen cross-sectional area (MLA) revealed that ACS lesions had significantly larger lipidic and necrotic areas than non-ACS lesions. Multivariate analysis revealed that the lipidic area at the MLA was an iMAP™ factor independently associated with ACS lesions (odds ratio -1.5, p=0.04). Based on receiver operating characteristic analysis with 4 different CL ranges, the lipidic area at the MLA with 25%-100% CL had the largest area under the curve (0.756), suggesting that 25%-100% is the best CL range for identifying ACS culprit lesions.

Conclusions: The feasibility of the novel iMAP™ IVUS system was shown in discriminating culprit lesions in patients with and without ACS. Analyzing with a CL of 25%-100% may be the best option for discriminating lesions.

Keywords: Acute coronary syndrome; Confidence level; IVUS; Tissue characterization; iMAP.

Publication types

  • Comparative Study

MeSH terms

  • Acute Coronary Syndrome / classification
  • Acute Coronary Syndrome / diagnostic imaging*
  • Acute Coronary Syndrome / surgery
  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / classification
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / surgery
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / methods*
  • Plaque, Atherosclerotic / classification
  • Plaque, Atherosclerotic / diagnostic imaging*
  • Plaque, Atherosclerotic / surgery
  • Retrospective Studies
  • Ultrasonography, Interventional / methods*