Published online before print February 4, 2002, doi: 10.1161/hc0802.104291
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(Circulation. 2002;105:923.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Detection of Lipid Pool, Thin Fibrous Cap, and Inflammatory Cells in Human Aortic Atherosclerotic Plaques by Near-Infrared Spectroscopy
From The Linda and Jack Gill Heart Institute, University of Kentucky (P.R.M., R.A.L., K.R.P., W.N.O.), Lexington; the Department of Surgery (W.E.C.), Boston University School of Medicine; the Cardiac Unit (J.E.M.), Massachusetts General Hospital, Harvard Medical School, Boston; and InfraReDx, Cambridge, Mass.
Correspondence to Pedro R. Moreno, MD, 111B-CDD, Veterans Administration Medical Center, 2250 Leestown Road, Lexington, KY 40511. E-mail pmoreno{at}uky.edu
Background— A method is needed to identify nonstenotic, lipid-rich coronary plaques that are likely to cause acute coronary events. Near-infrared (NIR) spectroscopy can provide information on the chemical composition of tissue. We tested the hypothesis that NIR spectroscopy can identify plaque composition and features associated with plaque vulnerability in human aortic atherosclerotic plaques obtained at the time of autopsy.
Methods and Results— A total of 199 samples from 5 human aortic specimens were analyzed by NIR spectroscopy. Features of plaque vulnerability were defined by histology as presence of lipid pool, thin fibrous cap (<65 µm by ocular micrometry), and inflammatory cell infiltration. An InfraAlyzer 500 spectrophotometer was used. Spectral absorbance values were obtained as log (1/R) data from 1100 to 2200 nm at 10-nm intervals. Principal component regression was used for analysis. An algorithm was constructed with 50% of the samples used as a reference set; blinded predictions of plaque composition were then performed on the remaining samples. NIR spectroscopy sensitivity and specificity for histological features of plaque vulnerability were 90% and 93% for lipid pool, 77% and 93% for thin cap, and 84% and 89% for inflammatory cells, respectively.
Conclusions— NIR spectroscopy can identify plaque composition and features associated with plaque vulnerability in postmortem human aortic specimens. These results support efforts to develop an NIR spectroscopy catheter system to detect vulnerable coronary plaques in living patients.
Key Words: atherosclerosis • plaque • tissue • spectroscopy
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