Author + information
- Received March 10, 2016
- Revision received May 31, 2016
- Accepted June 2, 2016
- Published online June 5, 2017.
- Yibin Xie, PhDa,b,
- Young-Jin Kim, MDc,
- Jianing Pang, PhDa,
- Jung-Sun Kim, MDd,
- Qi Yang, MDa,
- Janet Wei, MDa,
- Christopher T. Nguyen, PhDa,b,
- Zixin Deng, MSa,b,
- Byoung Wook Choi, MDc,
- Zhaoyang Fan, PhDa,
- C. Noel Bairey Merz, MDe,
- Prediman K. Shah, MDe,
- Daniel S. Berman, MDa,e,
- Hyuk-Jae Chang, MDd,f,∗∗ ( and )
- Debiao Li, PhDa,b,∗ ()
- aBiomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, California
- bDepartment of Bioengineering, University of California, Los Angeles, California
- cDepartment of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- dDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
- eHeart Institute, Cedars Sinai Medical Center, Los Angeles, California
- fBiomedical Imaging Institute, Yonsei University College of Medicine, Seoul, South Korea
- ↵∗Address for correspondence:
Dr. Debiao Li, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT Suite 800, Los Angeles, California 90048.
- ↵∗∗Dr. Hyuk-Jae Chang, Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.
Objectives The aim of this work is the development of coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) technique and the validation by comparison with high-risk plaque features (HRPF) observed on intracoronary optical coherence tomography (OCT) and invasive coronary angiography.
Background T1-weighted cardiac magnetic resonance with or without contrast media has been used for characterizing coronary atherosclerosis showing promising prognostic value. Several limitations include: 1) coverage is limited to proximal coronary segments; 2) spatial resolution is low and often anisotropic; and 3) a separate magnetic resonance angiography acquisition is needed to localize lesions.
Methods CATCH acquired dark-blood T1-weighted images and bright-blood anatomical reference images in an interleaved fashion. Retrospective motion correction with 100% respiratory gating efficiency was achieved. Reference control subjects (n = 13) completed both pre- and post-contrast scans. Stable angina patients (n = 30) completed pre-contrast scans, among whom 26 eligible patients also completed post-contrast scans. After cardiac magnetic resonance, eligible patients (n = 22) underwent invasive coronary angiography and OCT for the interrogation of coronary atherosclerosis. OCT images were assessed and scored for HRPF (lipid-richness, macrophages, cholesterol crystals, and microvessels) by 2 experienced analysts blinded to magnetic resonance results.
Results Per-subject analysis showed none of the 13 reference control subjects had coronary hyperintensive plaques (CHIP) in either pre-contrast or post-contrast CATCH. Five patients had CHIP on pre-contrast CATCH and 5 patients had CHIP on post-contrast CATCH. Patients with CHIP had greater lipid abnormality than those without. Per-segment analysis showed elevated pre- and post-contrast plaque to myocardium signal ratio in the lesions with HRPF versus those without. Positive correlation was observed between plaque to myocardium signal ratio and OCT HRPF scoring. CHIP on pre-contrast CATCH were associated with significantly higher stenosis level than non-CHIP on invasive coronary angiography.
Conclusions CATCH provided accelerated whole heart coronary plaque characterization with simultaneously acquired anatomical reference. CHIP detected by CATCH showed positive association with high-risk plaque features on invasive imaging studies.
- intraplaque hemorrhage
- magnetic resonance imaging
- optical coherence tomography
This work was supported by grants from the National Heart, Lung, and Blood Institute (R01HL096119), American Heart Association (15SDG25710441), National Science Foundation of China (81322022, 81229001), and Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning (2012027176). Dr. Bairey Merz has received consulting fees from Gilead, Medscape, and Research Triangle Institute International; fees for lectures to Beaumont Seventh Annual Heart Disease, Complex Cardio Catheter Therapeutics, European Horizon, Florida Hospital, Fifth Annual Flagstaff Cardiology Symposium, Inova Health System Symposium, Korean Cardiology Society, Primary Care Physician Symposium, Practice Point Communications, Valley Health Grand Rounds, Vascular Biology Working Group, University of Colorado, University of Utah, Washington University Grand Rounds, Women Heart, Harold Buchwald Heart Health, and Tufts Nicholson Lecture; and grants from Women's Ischemia Study Evaluation, Ranolazine Women's Ischemic Syndrome Evaluation, Microvascular, Normal Control, and Flight Attendant Medical Research Institute. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Xie and Y.-J. Kim contributed equally to this work.
- Received March 10, 2016.
- Revision received May 31, 2016.
- Accepted June 2, 2016.
- 2017 American College of Cardiology Foundation