Affiliation:
1. From Leiden University Medical Center (T.J.R.), Leiden, The Netherlands; Massachusetts Institute of Technology (J.F.B. III, G.D., M.S.F.), Cambridge, Mass; Medical Device Consultants, Inc (M.L.F.), North Attleboro, Mass; University Hospitals of Cleveland and Case Western Reserve University (M.F.), Cleveland, Ohio; The Cleveland Clinic Foundation (J.L.M., J.R.K.), Cleveland, Ohio; and Boston Heart Foundation & Division of Health Sciences and Technology, Harvard University and Massachusetts...
Abstract
Background
—Lesion composition, rather than size or volume, determines whether an atherosclerotic plaque will progress, regress, or rupture, but current techniques cannot provide precise quantitative information about lesion composition. We have developed a technique to assess the pathological state of human coronary artery samples by quantifying their chemical composition with near-infrared Raman spectroscopy.
Methods and Results
—Coronary artery samples (n=165) obtained from explanted recipient hearts were illuminated with 830-nm infrared light. Raman spectra were collected from the tissue and processed to quantify the relative weights of cholesterol, cholesterol esters, triglycerides and phospholipids, and calcium salts in the examined artery location. The artery locations were then classified by a pathologist and grouped as either nonatherosclerotic tissue, noncalcified plaque, or calcified plaque. Nonatherosclerotic tissue, which included normal artery and intimal fibroplasia, contained an average of ≈4±3% cholesterol, whereas noncalcified plaques had ≈26±10% and calcified plaques ≈19±10% cholesterol in the noncalcified regions. The average relative weight of calcium salts was 1±2% in noncalcified plaques and 41±21% in calcified plaques. To make this quantitative chemical information clinically useful, we developed a diagnostic algorithm, based on a first set of 97 samples, that demonstrated a strong correlation of the relative weights of cholesterol and calcium salts with histological diagnoses of the same locations. This algorithm was then prospectively tested on a second set of 68 samples. The algorithm correctly classified 64 of these new samples, thus demonstrating the accuracy and robustness of the method.
Conclusions
—The pathological state of a given human coronary artery may be assessed by quantifying its chemical composition, which can be done rapidly with Raman spectroscopic techniques. When Raman spectra are obtained clinically via optical fibers, Raman spectroscopy may be useful in monitoring the progression and regression of atherosclerosis, predicting plaque rupture, and selecting proper therapeutic intervention.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
154 articles.
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