New imaging technique may help pinpoint higher-risk cardiac patients

Register now

Researchers at Massachusetts General Hospital have developed an improved optical imaging technique that boosts the ability to diagnose coronary artery disease.

Those studying the technology said they found differences between potentially life-threatening coronary plaques and those posing less danger for patients. This method may give cardiologists additional data to identify cardiac patients who may have a higher risk of future heart attacks.

The research is getting additional support from the National Institute of Biomedical and Bio Engineering within the National Institutes of Health.

The focus is on patients suffering from angina, which may weaken over time if the angina is stable, but it seldom will cause a sudden heart attack. However, if the fibrous cap covering a lipid-filled atherosclerotic plaque ruptures and releases the plaque into the vessel, a blood clot can block the coronary artery and cause a heart attack.

That’s why cardiologists want to be able to distinguish stable coronary plaques from those prone to rupturing, says Behrouz Shabestari, director of the National Institute of Biomedical Imaging and Bioengineering at NIH. “The technique could be a game changer for cardiologists and their patients, offering refined insight into coronary arterial atherosclerotic lesions with quantifiable imaging data.”

The research is being led by Brett Bouma, a professor of dermatology, health sciences and technology, with work being done at Massachusetts General and Harvard Medical School.

The team has investigated polarization properties of coronary atherosclerotic plaques in 30 patients on a search for indications of plaque instability, and they gathered data using a technique for assessing the polarization properties of cross-sections of vascular tissue.

The study used 30 patients who had underwent cardiac catheterization that included intravascular imaging with optical coherence tomography to measure the polarization properties of the coronary artery wall. Intravascular imaging uses light in the near infrared range to get high-definition, cross-sectional images of the vessel wall.

Those 30 catheterizations provided a large volume of plaque images for each procedure, which included 342 cross-sectional plaque images and 244 images from the fibrous caps of the atherosclerotic responsible for high-risk or stable symptoms of participating patients.

“This is the first in-human pilot study of intravascular polarimetry Bouma,” says, noting that the fibrous caps of plaques prone to rupture now can be reliably identified using the in-human study. “Intravascular polarimetry may open new avenues for studying plaque composition and detecting high-risk patients.”

For reprint and licensing requests for this article, click here.