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Obstructive sleep apnea is associated with increased coronary plaque instability: an optical frequency domain imaging study.

ABSTRACT: Obstructive sleep apnea (OSA) is associated with coronary artery disease (CAD) and with an increased risk for myocardial infarction, stroke or death due to cardiovascular disease. Optical frequency-domain imaging (OFDI) is a useful modality for evaluating the characteristics of atherosclerotic plaque. The purpose of the study was to use OFDI to investigate the association of OSA with coronary plaque characteristics in patients undergoing percutaneous coronary intervention (PCI). We retrospectively analyzed OFDI data for coronary artery plaques from 15 patients with OSA and 35 non-OSA patients treated between October 2015 and October 2018. Plaque morphology was evaluated for 70 lesions, including 21 from patients with OSA and 49 from non-OSA patients. Compared with the non-OSA group, patients with OSA had significantly higher prevalences of thinned cap fibroatheroma (TCFA) (67% vs. 35%, P?=?0.014) and microchannels (86% vs. 55%, P?=?0.014); a significantly higher mean lipid index (1392?±?982 vs. 817?±?699, P?=?0.021), macrophage grade (8.4?±?6.4 vs. 4.8?±?4.5, P?=?0.030), and maximum number of microchannels (1.5?±?1.0 vs. 0.7?±?0.7, P?=?0.001); and a significantly lower mean minimum fibrous cap thickness (69.4?±?28.7 vs. 96.1?±?51.8 ?m, P?=?0.008). This OFDI analysis suggests that OSA is associated with unstable plaque characteristics in patients with CAD. More intensive medical management for stabilization of coronary atherosclerotic plaque is required in patients with OSA.

SUBMITTER: Konishi T

PROVIDER: S-EPMC6620247 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Obstructive sleep apnea is associated with increased coronary plaque instability: an optical frequency domain imaging study.

Konishi Takao T Kashiwagi Yusuke Y Funayama Naohiro N Yamamoto Tadashi T Murakami Hironori H Hotta Daisuke D Tanaka Shinya S

Heart and vessels 20190221 8

Obstructive sleep apnea (OSA) is associated with coronary artery disease (CAD) and with an increased risk for myocardial infarction, stroke or death due to cardiovascular disease. Optical frequency-domain imaging (OFDI) is a useful modality for evaluating the characteristics of atherosclerotic plaque. The purpose of the study was to use OFDI to investigate the association of OSA with coronary plaque characteristics in patients undergoing percutaneous coronary intervention (PCI). We retrospective ...[more]

PMID: 30790035

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Project description:ObjectivesThis study aimed to evaluate whether polarimetry, performed using a modified optical frequency domain imaging (OFDI) system, can improve the assessment of histological features relevant to characterizing human coronary atherosclerosis.BackgroundThe microscopic structure and organization of the arterial wall influence the polarization of the infrared light used by OFDI. Modification of the OFDI apparatus, along with recently developed image reconstruction methods, permits polarimetric measurements simultaneously with conventional OFDI cross-sectional imaging through standard intravascular imaging catheters.MethodsThe main coronary arteries of 5 cadaveric human hearts were imaged with an OFDI system capable of providing polarimetric assessment. Cross-sectional views of tissue birefringence, measured in refractive index units, and depolarization, expressed as the ratio of depolarized signal to total intensity, were reconstructed, together with conventional OFDI images. Following imaging, the vessels underwent histological evaluation to enable interpretation of the observed polarization features of individual tissue components.ResultsBirefringence in fibrous tissue was significantly higher than in intimal tissue with minimal abnormality (0.44 × 10-3 vs. 0.33 × 10-3; p < 0.0001). Birefringence was highest in the tunica media (p < 0.0001), consistent with its high smooth muscle cell content, cells known to associate with birefringence. In fibrous areas, birefringence showed fine spatial features and close correspondence with the histological appearance of collagen. In contrast, necrotic cores and regions rich in lipid elicited significant depolarization (p < 0.0001). Depolarization was also evident in locations of cholesterol crystals and macrophages.ConclusionsIntravascular measurements of birefringence and depolarization can be obtained using conventional OFDI catheters in conjunction with a modified console and signal processing algorithms. Polarimetric measurements enhance conventional OFDI by providing additional information related to the tissue composition and offer quantitative metrics enabling characterization of plaque features.

Dataset Information

Obstructive sleep apnea is associated with increased coronary plaque instability: an optical frequency domain imaging study.

Publications

Obstructive sleep apnea is associated with increased coronary plaque instability: an optical frequency domain imaging study.

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