Optical Coherence Tomography of Plaque Vulnerability and Rupture: JACC Focus Seminar Part 1/3

Plaque rupture is the most common cause of acute coronary syndromes and sudden cardiac death. Characteristics and pathobiology of vulnerable plaques prone to plaque rupture have been studied extensively over 2 decades in humans using optical coherence tomography (OCT), an intravascular imaging techn...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2021-09, Vol.78 (12), p.1257-1265
Main Authors: Aguirre, Aaron D, Arbab-Zadeh, Armin, Soeda, Tsunenari, Fuster, Valentin, Jang, Ik-Kyung
Format: Article
Language:English
Subjects:
Cardiac Imaging Techniques
Humans
Plaque, Atherosclerotic - diagnostic imaging
Rupture, Spontaneous - diagnostic imaging
Tomography, Optical Coherence
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Summary:Plaque rupture is the most common cause of acute coronary syndromes and sudden cardiac death. Characteristics and pathobiology of vulnerable plaques prone to plaque rupture have been studied extensively over 2 decades in humans using optical coherence tomography (OCT), an intravascular imaging technique with micron scale resolution. OCT studies have identified key features of plaque vulnerability and described the in vivo characteristics and spatial distribution of thin cap fibroatheromas as major precursors to plaque rupture. In addition, OCT data supports the evolving understanding of coronary heart disease as a panvascular process associated with inflammation. In the setting of high atherosclerotic burden, plaque ruptures often occur at multiple sites in the coronary arteries, and plaque progression and healing are dynamic processes modulated by systemic risk factors. This review details major investigations with intravascular OCT into the biology and clinical implications of plaque vulnerability and plaque rupture.
ISSN:1558-3597
DOI:10.1016/j.jacc.2021.06.050