TY - JOUR
T1 - Histopathologic validation of the intravascular ultrasound diagnosis of calcified coronary artery nodules
AU - Lee, Jin Bae
AU - Mintz, Gary S.
AU - Lisauskas, Jennifer B.
AU - Biro, Sinan G.
AU - Pu, Jun
AU - Sum, Stephen T.
AU - Madden, Sean P.
AU - Burke, Allen P.
AU - Goldstein, James
AU - Stone, Gregg W.
AU - Virmani, Renu
AU - Muller, James E.
AU - Maehara, Akiko
N1 - Funding Information:
Dr. Mintz has received consulting fees from Boston Scientific (Natick, Massachusetts), Volcano (Rancho Cordova, California), and Abbott Vascular (Abbott Park, Illinois). Ms. Lisauskas and Drs. Sum, Madden, and Muller are current employees of InfraReDx. Dr. Pu has received research grant from Boston Scientific China (Beijing, China). Drs. Burke and Virmani were consultants to InfraReDx for histologic studies. Dr. Goldstein is a consultant for and equity owner of InfraReDx. Dr. Stone has served on the advisory boards for and received honoraria from Boston Scientific and Abbott Vascular and has received research grants from InfraReDx and Volcano . Dr. Virmani is an advisory board member for Abbott Vascular, Arsenal Medical (Watertown, Massachusetts), Atrium (Hudson, New Hampshire), Lutonix (Maple Grove, Minnesota), Medtronic (Minneapolis, Minnesota), and W. L. Gore & Associates (Newark, Delaware). Dr. Maehara has received research grants from Boston Scientific and Volcano .
PY - 2011/12/1
Y1 - 2011/12/1
N2 - A calcified nodule is a type of potentially vulnerable plaque accounting for approximately 2% to 7% of coronary events. Because its intravascular ultrasound (IVUS) features have never been validated, the aim of this study was to assess the IVUS characteristics of calcified nodules in comparison to histopathology. IVUS was performed in 856 pathologic slices in 29 coronary arteries (11 left anterior descending, 5 left circumflex, and 13 right coronary arteries) in 18 autopsy hearts. Pathologic sections were analyzed every 2 mm; qualitative and quantitative findings of matched IVUS were analyzed. IVUS detected calcification in 285 frames; 17 (6.0%) were calcified nodules, and 268 (94.0%) were non-nodular calcium by histopathology. Two calcified nodules (11.8%) were solitary, and 15 (88.2%) were adjacent to non-nodular calcium. IVUS characteristics of calcified nodules were (1) a convex shape of the luminal surface (94.1% in calcified nodules vs 9.7% in non-nodular calcium, p <0.001), (2) a convex shape of the luminal side of calcium (100% vs 16.0%, p <0.001), (3) an irregular luminal surface (64.7% vs 11.6%, p <0.001), and (4) an irregular leading edge of calcium (88.2% vs 19.0%, p <0.001). Luminal area at the calcified nodule site was larger (6.2 ± 2.4 vs 4.3 ± 1.6 mm 2, p <0.001) and plaque burden less (57 ± 6% vs 68 ± 5%, p <0.001) than at the minimum luminal area site. In conclusion, calcified nodules have distinct IVUS features (irregular and convex luminal surface) permitting their prospective identification in vivo.
AB - A calcified nodule is a type of potentially vulnerable plaque accounting for approximately 2% to 7% of coronary events. Because its intravascular ultrasound (IVUS) features have never been validated, the aim of this study was to assess the IVUS characteristics of calcified nodules in comparison to histopathology. IVUS was performed in 856 pathologic slices in 29 coronary arteries (11 left anterior descending, 5 left circumflex, and 13 right coronary arteries) in 18 autopsy hearts. Pathologic sections were analyzed every 2 mm; qualitative and quantitative findings of matched IVUS were analyzed. IVUS detected calcification in 285 frames; 17 (6.0%) were calcified nodules, and 268 (94.0%) were non-nodular calcium by histopathology. Two calcified nodules (11.8%) were solitary, and 15 (88.2%) were adjacent to non-nodular calcium. IVUS characteristics of calcified nodules were (1) a convex shape of the luminal surface (94.1% in calcified nodules vs 9.7% in non-nodular calcium, p <0.001), (2) a convex shape of the luminal side of calcium (100% vs 16.0%, p <0.001), (3) an irregular luminal surface (64.7% vs 11.6%, p <0.001), and (4) an irregular leading edge of calcium (88.2% vs 19.0%, p <0.001). Luminal area at the calcified nodule site was larger (6.2 ± 2.4 vs 4.3 ± 1.6 mm 2, p <0.001) and plaque burden less (57 ± 6% vs 68 ± 5%, p <0.001) than at the minimum luminal area site. In conclusion, calcified nodules have distinct IVUS features (irregular and convex luminal surface) permitting their prospective identification in vivo.
UR - http://www.scopus.com/inward/record.url?scp=80955144214&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2011.07.014
DO - 10.1016/j.amjcard.2011.07.014
M3 - Article
C2 - 21872195
AN - SCOPUS:80955144214
SN - 0002-9149
VL - 108
SP - 1547
EP - 1551
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -