Intracoronary dual-modal optical coherence tomography-near-infrared fluorescence structural-molecular imaging with a clinical dose of indocyanine green for the assessment of high-risk plaques and stent-associated inflammation in a beating coronary artery
- Authors
- Kim, Sunwon; Lee, Min Woo; Kim, Tae Shik; Song, Joon Woo; Nam, Hyeong Soo; Cho, Han Saem; Jang, Sun-Joo; Ryu, Jiheun; Oh, Dong Joo; Gweon, Dae-Gab; Park, Seong Hwan; Park, Kyeongsoon; Oh, Wang-Yuhl; Yoo, Hongki; Kim, Jin Won
- Issue Date
- 1-10월-2016
- Publisher
- OXFORD UNIV PRESS
- Keywords
- Atherosclerosis; Inflammation; Imaging; Plaque; Stents
- Citation
- EUROPEAN HEART JOURNAL, v.37, no.37, pp.2833 - 2844
- Indexed
- SCIE
SCOPUS
- Journal Title
- EUROPEAN HEART JOURNAL
- Volume
- 37
- Number
- 37
- Start Page
- 2833
- End Page
- 2844
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/87218
- DOI
- 10.1093/eurheartj/ehv726
- ISSN
- 0195-668X
- Abstract
- Aims Inflammation plays essential role in development of plaque disruption and coronary stent-associated complications. This study aimed to examine whether intracoronary dual-modal optical coherence tomography (OCT)-near-infrared fluorescence (NIRF) structural-molecular imaging with indocyanine green (ICG) can estimate inflammation in swine coronary artery. Methods and results After administration of clinically approved NIRF-enhancing ICG (2.0 mg/kg) or saline, rapid coronary imaging (20 mm/s pullback speed) using a fully integrated OCT-NIRF catheter was safely performed in 12 atheromatous Yucatan minipigs and in 7 drug-eluting stent (DES)-implanted Yorkshire pigs. Stronger NIRF activity was identified in OCT-proven high-risk plaque compared to normal or saline-injected controls (P = 0.0016), which was validated on ex vivo fluorescence reflectance imaging. In vivo plaque target-to-background ratio (pTBR) was much higher in inflamed lipid-rich plaque compared to fibrous plaque (P < 0.0001). In vivo and ex vivo peak pTBRs correlated significantly (P < 0.0022). In vitro cellular ICG uptake and histological validations corroborated the OCT-NIRF findings in vivo. Indocyanine green colocalization with macrophages and lipids of human plaques was confirmed with autopsy atheroma specimens. Two weeks after DES deployment, OCT-NIRF imaging detected strong NIRF signals along stent struts, which was significantly higher than baseline (P = 0.0156). Histologically, NIRF signals in peri-strut tissue co-localized well with macrophages. Conclusion The OCT-NIRF imaging with a clinical dose of ICG was feasible to accurately assess plaque inflammation and DES-related inflammation in a beating coronary artery. This highly translatable dual-modal molecular-structural imaging strategy could be relevant for clinical intracoronary estimation of high-risk plaques and DES biology.
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