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Current Cardiovascular Imaging Reports
Published in: Current Cardiovascular Imaging Reports 9/2017

01-09-2017 | Intravascular Imaging (IK Jang, Section Editor)

Clinical Utility of Virtual Histology Intravascular Ultrasound

Authors: Akiko Maehara, Gary S. Mintz

Published in: Current Cardiovascular Imaging Reports | Issue 9/2017

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Abstract

Purpose of Review

Tissue characterization using imaging is important to understand the pathophysiology of atherosclerosis and subsequent outcomes. In this review, the clinical utility of virtual histology intravascular ultrasound (VH-IVUS), which provides a quantitative and more objective evaluation of tissue characterization compared with grayscale IVUS, will be summarized.

Recent Findings

Patient clinical characteristics, including coronary risk factors and medications, are associated with lesion morphology, especially plaque vulnerability. Different levels of vulnerability cause different clinical presentations and associated long-term outcomes. For example, in the first natural history study (Providing Regional Observations to Study Predictors of Events in the Coronary Tree [PROSPECT]), we showed that large plaque burden, small lumen area, and presence of thin-cap fibroatheroma were associated with subsequent outcomes at 3-year follow-up.

Summary

VH-IVUS has contributed significantly to our understanding of atherosclerosis.
Literature
1.
• Nair A, Kuban BD, Tuzcu EM, et al. Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation. 2002;106:2200–6. This is the first paper to show the quantitative assessment of tissue characterization by VH-IVUS. CrossRefPubMed
2.
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•• Stone GW, Maehara A, Lansky AJ, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364:226–35. This is the first prospective natural history of atherosclerosis study to show the importance of plaque burden, lumen narrowing, and thin-cap fibroatheroma by VH-IVUS to predict future events. CrossRefPubMed
6.
• Maehara A, Cristea E, Mintz GS, et al. Definitions and methodology for the grayscale and radiofrequency intravascular ultrasound and coronary angiographic analyses. JACC Cardiovasc Imaging. 2012;5:S1–9. This describes (in detail) the definitions and methodology of VH-IVUS. CrossRefPubMed
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12.
Kadohira T, Mintz GS, Souza CF, et al. Impact of chronic statin therapy on clinical presentation and underlying lesion morphology in patients undergoing percutaneous intervention: an ADAPT-DES IVUS substudy. Coron Artery Dis. 2017;28:218–24.CrossRefPubMed
13.
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14.
Baber U, Stone GW, Weisz G, et al. Coronary plaque composition, morphology, and outcomes in patients with and without chronic kidney disease presenting with acute coronary syndromes. JACC Cardiovasc Imaging. 2012;5:S53–61.CrossRefPubMed
15.
Chin CY, Mintz GS, Saito S, et al. Relation between renal function and coronary plaque morphology (from the assessment of dual antiplatelet therapy with drug-eluting stents virtual histology-intravascular ultrasound substudy). Am J Cardiol. 2017;119:217–24.CrossRefPubMed
16.
Kang SJ, Mintz GS, Weisz G, et al. Age-related effects of smoking on coronary artery disease assessed by gray scale and virtual histology intravascular ultrasound. Am J Cardiol. 2015;115:1056–62.CrossRefPubMed
17.
Kang SJ, Mintz GS, Witzenbichler B, et al. Age-related effects of smoking on culprit lesion plaque vulnerability as assessed by grayscale and virtual histology-intravascular ultrasound. Coron Artery Dis. 2015;26:476–83.CrossRefPubMed
18.
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19.
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20.
Guo J, Maehara A, Mintz GS, et al. A virtual histology intravascular ultrasound analysis of coronary chronic total occlusions. Catheter Cardiovasc Interv. 2013;81:464–70.CrossRefPubMed
21.
Kang SJ, Mintz GS, Park DW, et al. Tissue characterization of in-stent neointima using intravascular ultrasound radiofrequency data analysis. Am J Cardiol. 2010;106:1561–5.CrossRefPubMed
22.
Kang SJ, Mintz GS, Akasaka T, et al. Optical coherence tomographic analysis of in-stent neoatherosclerosis after drug-eluting stent implantation. Circulation. 2011;123:2954–63.CrossRefPubMed
23.
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24.
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25.
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26.
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27.
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28.
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29.
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30.
Kubo T, Maehara A, Mintz GS, et al. The dynamic nature of coronary artery lesion morphology assessed by serial virtual histology intravascular ultrasound tissue characterization. J Am Coll Cardiol. 2010;55:1590–7.CrossRefPubMed
31.
Zhao Z, Witzenbichler B, Mintz GS, et al. Dynamic nature of nonculprit coronary artery lesion morphology in STEMI. A serial IVUS analysis from the HORIZONS-AMI trial. JACC Cardiovasc Imaging. 2013;6:86–95.CrossRefPubMed
32.
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33.
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34.
Yun KH, Mintz GS, Farhat N, et al. Relation between angiographic lesion severity, vulnerable plaque morphology and futures adverse cardiac events (from the providing regional observations to study predictors of events in the coronary tree study). Am J Cardiol. 2012;110:471–7.CrossRefPubMed
35.
Xu Y, Mintz GS, Tam A, et al. Prevalence, distribution, predictors, and outcomes of patients with calcified nodules in native coronary arteries. A 3-vessel intravascular ultrasound analysis from providing regional observations to study predictors of events in the coronary tree (PROSPECT). Circulation. 2012;126:537–45.CrossRefPubMed
36.
Dohi T, Mintz GS, McPherson JA, et al. Non-fibroatheroma lesion phenotype and long-term clinical outcomes. A substudy analysis from the PROSPECT study. JACC Cardiovasc Img. 2013;6:908–16.CrossRef
37.
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38.
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Metadata
Title
Clinical Utility of Virtual Histology Intravascular Ultrasound
Authors
Akiko Maehara
Gary S. Mintz
Publication date
01-09-2017
Publisher
Springer US
Published in
Current Cardiovascular Imaging Reports / Issue 9/2017
Print ISSN: 1941-9066
Electronic ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-017-9426-0

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