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  • 1
    Electronic Resource
    Electronic Resource
    Intravascular ultrasound insights into plaque composition (2000)
    Springer
    Zeitschrift für Kardiologie 89 (2000), S. S117 
    Details
    ISSN: 1435-1285
    Keywords: Key words Intravascular ultrasound – coronary artery disease – plaque tissue characterization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Previous studies correlating histomorphology with 20–30 MHz-derived intravascular ultrasound (IVUS) images showed that IVUS provides to some extent qualitative information on plaque composition. IVUS imaging proved to define calcifications with high sensitivity and specificity but was found to be less accurate in the assessment of soft components. Nevertheless previous studies on atherosclerotic plaque characterization were limited by use of low-frequency transducers that did not define accurately soft components. Our goal was to test the effectiveness of high frequency IVUS transducers in the identification of lipid/necrotic pools in atherosclerotic plaques. Methods: Forty MHz transducers were used for in vitro IVUS assessment of 12 arterial segments (10 coronary arteries and 2 carotid arteries dissected from 5 different autopsy cases). IVUS acquisition was performed at a 0.5 mm/s speed after ligature of the branching points to generate a closed system. Lipid necrotic areas were defined by IVUS as large echolucent intraplaque areas surrounded by tissue with higher echodensity. To obtain histopathologic sections corresponding to IVUS cross sections, vessels were divided into consecutive 3 mm-long segments using the most distal recorded IVUS image as the starting reference. Then, samples were fixed with 10% buffered formalin, processed for histopathologic study, serially cut, and stained with the Movat penthacrome method. Results: One hundred twenty-two sections were analyzed. Lipid pools were observed by histology in 30 cross sections (25%). IVUS revealed the presence of lipid pools in 19 of 122 cross sections with a sensitivity and specificity of 67% and 94%, respectively. Conclusions: High frequency transducers accurately identify lipid/necrotic pools and open new perspectives on future IVUS characterization of atherosclerotic plaques.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003920070110
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Value of low-dose echodobutamine in the diagnosis of patency of the infarct related coronary artery (1994)
    Springer
    The international journal of cardiovascular imaging 10 (1994), S. 131-136 
    Details
    ISSN: 1573-0743
    Keywords: echodobutamine testing ; infarct related coronary artery ; viable myocardium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The resumption of contractility of asynergic segments in survivors after acute myocardial infarction (AMI) may be detected in viable myocardial areas. We have correlated the detection of viable myocardium, assessed with low dose dobutamine testing, with coronary angiography and clinical outcome in 66 consecutive survivors of AMI using the echocardiographic evidence of left ventricular wall motion abnormalities. The test enabled the identification of two groups: group A, comprising 32 patients (pts) demonstrating wall motion recovery at dobutamine infusion and group B, comprising 34 pts without wall motion recovery. The mean basal asynergy score index was 5.8±4.2 in group A and 6.0±4.2 in group B (p = ns). With dobutamine testing the score decreased to 2.8±3.6 in group A (p 〈 0.001 with respect to basal value), while it did not change significantly in group B. Left ventricular end diastolic volume (ml) was similar in the two groups (114±35 vs 107±79, p = NS). The infarct related artery (IRA) patency rate was 87.5% in group A, vs 26.5% in group B (p 〈 0.001). After a mean follow-up of 11±5 months, group A pts had basal asynergy score improvement (2.6±3.1, p 〈 0.001) and mild left ventricular end diastolic volume (ml) reduction, (108±32, p = NS), while group B pts had left ventricle end diastolic volume enlargement (130±38, p 〈 0.05), without score asynergy modification. Moreover all pts who experienced heart failure at follow-up were in group B. In our study, wall motion recovery with low dose dobutamine testing detects IRA patency after a first AMI (sensitivity 76%, specificity 86%, diagnostic accuracy 80%, positive predictive value 87%, negative predictive value 73%). IRA patency seems to be related to left ventricular volume reduction and wall motion improvement at follow-up. Low dose dobutamine echocardiography could be useful in detecting pts at risk of left ventricular enlargement after a first AMI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01137708
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    Paper (German National Licenses)
    Fulltext
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