Optical Coherence Tomography of Plaque Vulnerability and Rupture: JACC Focus Seminar Part 1/3

Aaron D. Aguirre, Armin Arbab-Zadeh, Tsunenari Soeda, Valentin Fuster, Ik Kyung Jang

Research output: Contribution to journalReview articlepeer-review

42 Scopus citations

Abstract

Plaque rupture is the most common cause of acute coronary syndromes and sudden cardiac death. Characteristics and pathobiology of vulnerable plaques prone to plaque rupture have been studied extensively over 2 decades in humans using optical coherence tomography (OCT), an intravascular imaging technique with micron scale resolution. OCT studies have identified key features of plaque vulnerability and described the in vivo characteristics and spatial distribution of thin cap fibroatheromas as major precursors to plaque rupture. In addition, OCT data supports the evolving understanding of coronary heart disease as a panvascular process associated with inflammation. In the setting of high atherosclerotic burden, plaque ruptures often occur at multiple sites in the coronary arteries, and plaque progression and healing are dynamic processes modulated by systemic risk factors. This review details major investigations with intravascular OCT into the biology and clinical implications of plaque vulnerability and plaque rupture.

Original languageEnglish
Pages (from-to)1257-1265
Number of pages9
JournalJournal of the American College of Cardiology
Volume78
Issue number12
DOIs
StatePublished - 21 Sep 2021

Keywords

  • acute coronary syndrome
  • optical coherence tomography
  • plaque rupture
  • plaque vulnerability
  • vascular biology

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