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Comparison of Early Coronary Artery Calcification with Intravascular Ultrasound and Micro Computed Tomography
Author(s) -
Strobel John,
Tram Nguyen,
Alloosh Mouhamad,
Byrd James,
Song Leo,
Chou TingHeng,
Stacy Mitchel,
Sturek Michael
Publication year - 2021
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2021.35.s1.04824
Subject(s) - intravascular ultrasound , calcification , medicine , coronary arteries , echogenicity , artery , radiology , stenosis , coronary artery disease , cardiology , ultrasound , coronary atherosclerosis
Background Early calcification is a strong predictor of unstable plaque and acute coronary events. Clinical intravascular ultrasound (IVUS) with a resolution of ~200 µm is a sensitive measure of calcification, but has never been compared to micro computed tomography (micro CT), which has ~10‐fold higher spatial resolution. IVUS is performed by producing sound waves to produce a 360‐degree cross‐sectional image of the vascular wall while micro‐CT uses X‐rays to produce high‐resolution 3D vascular images. We quantified and compared the extent of vascular calcification in the left anterior descending (LAD) artery of atherosclerotic swine using ex vivo micro‐CT and in vivo IVUS. Methods Ossabaw miniature swine were placed on a diet high in calories, fat, cholesterol, and fructose for 12 months, which elicited metabolic syndrome (MetS), coronary atherosclerosis, and calcification. Angiography was performed for visualization of the coronary arteries. Interrogation of the left anterior descending (LAD) coronary artery was conducted in vivo using IVUS and calcification was defined as high echogenic regions with complete peripheral acoustic shadowing. The coronary arteries were then harvested for ex vivo micro‐CT analysis. Both IVUS and micro‐CT were analyzed for vascular calcification at 1 mm intervals. Results All LAD arteries displayed heterogeneous calcification. Specifically, IVUS revealed in the 75 mm of artery interrogated a plaque burden average of 23% and 18 sites of calcification. One segment had 59% plaque burden, indicating a flow‐limiting stenosis. Micro CT did not resolve plaque burden, but showed 35 sites of calcification in the 75 mm of LAD arteries that were assessed. Conclusion Micro CT imaging allows for greater detection of vascular calcification in coronary arteries compared to IVUS, but cannot assess calcification in vivo in large animals. Future studies should compare the sensitivity of clinical CT and IVUS for detecting in vivo serial changes in coronary artery calcification during the stages of atherosclerosis disease progression.