Intracoronary Laser Speckle Imaging for Atherosclerotic Plaque Diagnosis

冠状动脉内激光散斑成像用于动脉粥样硬化斑块诊断

• 批准号: 7587942
• 负责人: Seemantini K Nadkarni
• 金额: $ 21.91万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-20 至 2012-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7587942
• 关键词: Acute; Address; Anatomy; Animal Model; Animals; Area; Arterial Fatty Streak; Arteries; Atherosclerosis; Back; Biomechanics; Blood flow; Cardiac; Cardiovascular Diseases; Catheterization; Catheters; Cause of Death; Clinical; Collagen; Coronary; Coronary Arteriosclerosis; Custom; Detection; Development; Diagnosis; Diagnostic; Evaluation; Event; Family suidae; Feasibility Studies; Fiber; Goals; Human; Image; Imaging Device; Imaging Techniques; Imaging technology; Laboratories; Lasers; Life; Lighting; Link; Measurement; Measures; Mediating; Methods; Modeling; Morbidity - disease rate; Motion; Necrosis; Optics; Patients; Pattern; Performance; Physiological; Physiology; Process; Research; Research Proposals; Rupture; Screening procedure; Sensitivity and Specificity; Site; Societies; Specimen; Speed; Structure; System; Techniques; Technology; Testing; Thick; Thrombus; Time; Tissues; Translations; Work; Xenograft Model; Xenograft procedure; acute coronary syndrome; base; design; diagnostic accuracy; experience; heart motion; high risk; improved; in vivo; indexing; insight; instrumentation; light scattering; mortality; novel; optical fiber; particle; tissue phantom; tool; viscoelasticity

DESCRIPTION (provided by applicant): The rupture of unstable atherosclerotic plaque is the most frequent event leading to thrombus mediated ischemic cardiovascular disease, which remains the leading cause of mortality in industrialized societies. The processes leading to plaque vulnerability are multi-factorial, and it is widely conceived that an intricate interplay between biomechanical, compositional and morphological determinants of atherosclerosis influences plaque stability. The development of novel intracoronary imaging techniques that provide composite information about these factors is vital for identifying rupture-prone atherosclerotic plaques, guiding therapy, and for providing insights regarding plaque stabilization in patients. We recently showed that Laser Speckle Imaging (LSI), a new optical technique which measures the Brownian motion of endogenous particles in tissue, is highly sensitive for evaluating plaque viscoelasticity, composition and structure. Our prior work, conducted on cadaveric arterial specimens demonstrated that LSI has high accuracy for diagnosing atherosclerotic plaque type, measuring collagen content, and necrotic core area, and determining fibrous cap thickness. The goal of the current proposal is to develop an LSI system and catheter for in vivo intracoronary use. We envision that this work will potentially yield a single platform to evaluate coronary plaque biomechanics, composition and structure in patients. The Aims of this proposal are motivated by our prior experience in investigating the diagnostic potential of LSI and the expertise of our laboratory in fabricating miniature optical catheters for human use. Although we have demonstrated the principles of LSI ex vivo, the development of an intracoronary LSI catheter and system capable of imaging long coronary segments in vivo presents considerable technical challenges. In Aim 1 of this research we will focus on overcoming these challenges by developing LSI instrumentation and an intracoronary catheter capable of evaluating coronary vasculature in the presence of blood flow and cardiac motion. The diagnostic accuracy of LSI in identifying plaque type and characterizing structural features will be determined using ex vivo arterial tissue and phantom studies. In Aim 2 of this work we will demonstrate the feasibility of intracoronary LSI using a human to swine coronary xenograft living animal model to permit evaluation of human atherosclerotic plaques under in vivo physiological conditions. With the successful culmination of the aims of this proposal, we will have developed a novel intracoronary LSI technique and validated critical milestones in its path to clinical applicability.Narrative Acute coronary syndromes frequently result from the rupture of unstable coronary plaque. Intracoronary Laser Speckle Imaging will potentially provide a unique method to evaluate multiple determinants of plaque stability and facilitate the detection of high-risk coronary plaques in patients.

描述（由申请人提供）：不稳定的动脉粥样硬化斑块破裂是导致血栓介导的缺血性心血管疾病的最常见事件，这仍然是工业化社会死亡率的主要原因。导致斑块脆弱性的过程是多因素的，人们普遍认为，动脉粥样硬化的生物力学，组成和形态决定因素之间的复杂相互作用会影响斑块稳定性。提供有关这些因素的综合信息的新型冠状化成像技术的发展对于识别可破裂的动脉粥样硬化斑块，指导疗法以及提供有关患者斑块稳定的见解至关重要。我们最近表明，激光斑点成像（LSI）是一种新的光学技术，可测量组织中内源性颗粒的布朗运动，对评估斑块粘弹性，组成和结构非常敏感。我们先前在尸体动脉标本上进行的工作表明，LSI在诊断动脉粥样硬化斑块类型，测量胶原蛋白含量和坏死的核心区域以及确定纤维帽厚度方面具有很高的精度。当前建议的目的是开发用于体内冠状动脉内使用的LSI系统和导管。我们设想这项工作将有可能产生一个平台，以评估患者的冠状动脉生物力学，组成和结构。 该提案的目的是我们先前在研究LSI诊断潜力的经验以及实验室在制造微型光导管以供人类使用的诊断潜力的经验。尽管我们已经证明了LSI离体的原理，但冠状内LSI导管的发展和能够对体内长期冠状动脉片段进行成像的系统提出了巨大的技术挑战。在这项研究的目标1中，我们将专注于通过开发LSI仪器和能够在血液流动和心脏运动的情况下评估冠状动脉脉管系统来克服这些挑战。 LSI在鉴定斑块类型和表征结构特征方面的诊断准确性将使用离体动脉组织和幻影研究确定。在这项工作的目标2中，我们将使用人类到猪冠状动脉异种移植动物模型来证明冠状动脉内LSI的可行性，以允许在体内生理条件下对人动脉粥样硬化斑块进行评估。随着该提案目标的成功结晶，我们将开发出一种新颖的冠状内LSI技术，并在其临床适用性方面验证了关键里程碑。 急性冠状动脉综合征经常是由于不稳定的冠状斑块破裂而引起的。冠状动脉内激光斑点成像将有可能提供一种独特的方法来评估斑块稳定性的多种决定因素，并促进患者中高危冠状动脉斑块的检测。