Multimodality direct coronary imaging with combined near‐infrared spectroscopy and intravascular ultrasound: Initial US experience

Recent studies emphasize the importance of direct intracoronary imaging techniques that provide insights regarding not only lesion architecture but also plaque composition, particularly the presence or absence of lipid‐core plaque (LCP). Intracoronary near‐infrared spectroscopy (NIRS) is the only validated FDA approved device for in vivo detection of LCP. A recently introduced catheter provides simultaneous NIRS spectral data coregistered with standard intravascular ultrasound (IVUS) images in a single intracoronary pullback. The present series of cases illustrates the unique data obtained by this combined NIRS‐IVUS device and highlights its potential clinical applications. © 2012 Wiley Periodicals, Inc.     

Reduced frontal activation during verbal fluency task in chronic hepatitis C patients with interferon‐based therapy as measured by near‐infrared spectroscopy

Aim

Psychiatric side‐effects are the main reason for discontinuation of interferon (IFN)‐based therapy. Recent developments in near‐infrared spectroscopy (NIRS) have enabled non‐invasive clarification of brain functions in psychiatric disorders. We prospectively evaluated brain activation in 20 chronic hepatitis C patients with or without IFN‐based therapy by using NIRS during a verbal fluency task (VFT).

Methods

The relative concentrations of oxygenated hemoglobin were measured while patients completed a questionnaire survey at the start of treatment and at 4 and 12 weeks during treatment, using NIRS.

Results

The VFT performance did not change among the two groups. Patients with IFN‐based therapy showed significantly lower activation during VFT in frontal channels at 12 weeks than those at the start of treatment and control (P < 0.05). Their Center for Epidemiologic Studies Depression Scale scores were significantly higher at 12 weeks than those at the start of treatment, although major depressive symptoms were not found (8.3 ± 7.9 vs. 13.2 ± 6.0, P < 0.001).

Conclusion

The decrease in oxygenated hemoglobin concentrations of the frontal lobe detected using NIRS in this study reflects hypofunction of the frontal lobe. This functional decline that was caused by IFN‐based therapy may be associated with the prodromal phase of depression.

     

Reproducibility of near‐infrared spectroscopy for the detection of lipid core coronary plaques and observed changes after coronary stent implantation

Objectives : To evaluate the reproducibility of catheter‐based intracoronary near‐infrared spectroscopy (NIRS) for the detection of lipid core coronary plaques (LCPs) and to examine stenting‐induced changes in NIRS findings. Background : The in‐vivo reproducibility of coronary NIRS findings and their changes after stenting have not previously been characterized. Methods : NIRS assessment using an automated pullback catheter was performed in duplicate in 36 vessels in 31 patients. The reproducibility of the Lipid Core Burden Index (LCBI) and the presence and number of LCPs was assessed. The changes in LCBI after stenting were also assessed in 25 vessels in 22 patients. Results : LCBI of the first and second pullback was 64 ± 43 and 70 ± 62, respectively, with excellent correlation (Spearman's rho 0.927, intraclass correlation coefficient 0.925). Depending on LCP definition, mean LCP length, and median LCP number ranged from 2.44 to 17.25 mm, and from 0 to 2, respectively per artery studied. High correlation was observed between the two pullbacks for total LCP length (depending on the LCP definition used, the Spearman's rho and the intraclass correlation coefficient ranged from 0.72 to 0.89, and from 0.76 to 0.91, respectively) and for LCP number (depending on the LCP definition used, the Spearman's rho and the intraclass correlation coefficient ranged from 0.70 to 0.87, and from 0.67 to 0.88, respectively). The mean LCBI decreased by 40% from 78 ± 47 to 48 ± 38 after stenting (P < 0.001). Conclusion : The LCBI and LCP length NIRS measurements have high reproducibility. LCBI significantly decreases after coronary stenting. © 2010 Wiley‐Liss, Inc.