[1]林子健 许俊炜 陈剑 陈柏荣 罗礼云.血管内超声衰减斑块的研究进展[J].心血管病学进展,2023,(4):312.[doi:10.16806/j.cnki.issn.1004-3934.2023.04.006]
 LIN Zijian,XU Junwei,CHEN Jian,et al.Attenuated Plaque Identified by Intravascular Ultrasound[J].Advances in Cardiovascular Diseases,2023,(4):312.[doi:10.16806/j.cnki.issn.1004-3934.2023.04.006]
点击复制

血管内超声衰减斑块的研究进展()
分享到:

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2023年4期
页码:
312
栏目:
综述
出版日期:
2023-04-25

文章信息/Info

Title:
Attenuated Plaque Identified by Intravascular Ultrasound
作者:
林子健 许俊炜 陈剑 陈柏荣 罗礼云
(中山大学附属第五医院心血管病中心,广东 珠海519000)
Author(s):
LIN ZijianXU JunweiCHEN JianCHEN BairongLUO Liyun
(Cardiovascular Center, The Fifth Affiliated Hospital of Sun Yat-sen University ,Zhuhai 519000,Guangdong,China)
关键词:
冠心病经皮冠状动脉介入治疗血管内超声衰减斑块
Keywords:
Coronary heart diseasePercutaneous coronary interventionIntravascular ultrasound Attenuated plaque
DOI:
10.16806/j.cnki.issn.1004-3934.2023.04.006
摘要:
衰减斑块是血管内超声识别的伴有超声衰减现象的易损斑块特征之一,其主要病理特征为具有巨大脂质/坏死核心,衰减斑块成分中的胆固醇结晶及点状钙化对超声的折射和吸收导致超声波无法穿过斑块而表现为超声衰减现象,常见于急性冠脉综合征,与冠心病患者主要不良心血管事件增加相关,且增加经皮冠状动脉介入治疗术中无复流、围手术期心肌坏死及斑块脱垂等并发症的发生风险。现从衰减斑块的定义、病理机制、临床意义、预后及临床治疗策略等方面进行综述,同时对人工智能及血管内超声/光学相干断层扫描成像集合导管在衰减斑块领域的新技术应用方面进行展望。
Abstract:
Attenuated plaque is one of the features of the vulnerable plaque with ultra sound attenuation phenomenon identified by i ntravascular ultrasound, which is characterized by containing a?large?lipid-necrotic?core.The cholesterol crystals and spotty calcification in the attenuated plaque refracted and absorb the ultrasound, which resulted in the ultrasound unable to pass through the plaque, and lead toultrasound attenuation phenomenon.Attenuated plaque is commonly seen in patients with acute coronary syndrome, and is associated with an?increased?risk for?major?adverse?cardiovascular?events in patients with coronary heart disease, and increases the risk of complications such as no reflow during percutaneous coronary intervention, perioperative myocardial necrosis and plaque prolapse. In this review, we will review the definition, pathological mechanism, clinical significances, prognosis and clinical treatment strategies of coronary ultrasound attenuated plaque, and prospect the application of artificial intelligence and IVUS/OCT converging catheter in the field of coronary ultrasound attenuated plaque

参考文献/References:

[1].Ono M,Kawashima H,Hara H,et al.Advances in IVUS/OCT and future clinical perspective of novel hybrid catheter system in coronary imaging[J].Front Cardiovasc Med,2020,7:119.
[2].Lawton JS, Tamis-Holland JE, Bangalore S,et al.2021 ACC/AHA/SCAI Guideline for coronary artery revascularization:executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [J].Circulation,145,3(2022):e4-e17.
[3].张迪瑞,何路平,于波.腔内影像学对冠状动脉易损斑块的识别与治疗最新进展[J].中国介入心脏病学杂志,2021,29(9):520-522.
[4].Kang SJ,Ahn JM,Han S,et al. Multimodality imaging of attenuated plaque using grayscale and virtual histology intravascular ultrasound and optical coherent tomography[J].Catheter Cardiovasc Interv,2016,88(1):e1-e11.
[5].Hong YJ,Ahn Y,Jeong MH. Role of intravascular ultrasound in patients with acute myocardial infarction[J]. Korean Circ J,2015,45(4):259-265.
[6].Kimura S,Kakuta T,Yonetsu T,et al. Clinical significance of echo signal attenuation on intravascular ultrasound in patients with coronary artery disease[J]. Circ Cardiovasc Interv,2009,2(5):444-454.
[7].Shishikura D,Kataoka Y,di Giovanni G,et al. Progression of ultrasound plaque attenuation and low echogenicity associates with major adverse cardiovascular events[J]. Eur Heart J,2020,41(31):2965-2973.
[8].Wu XF,Guo CJ,Chi YP,et al. Attenuated plaque is associated with plaque prolapse accompanied by cardiac enzyme elevation after drug-eluting stent implantation[J].Coron Artery Dis,2014,25(1):4-9.
[9].Hoshino M,Yonetsu T,Murai T,et al. Multimodality coronary imaging to predict periprocedural myocardial necrosis after an elective percutaneous coronary intervention[J]. Coron Artery Dis,2018,29(3):237-245.
[10].Kimura S,Sugiyama T,Hishikari K,et al. Association of intravascular ultrasound- and optical coherence tomography-assessed coronary plaque morphology with periprocedural myocardial injury in patients with stable angina pectoris[J]. Circ J,2015,79(9):1944-1953.
[11].Hafiane A. Vulnerable plaque,characteristics,detection,and potential therapies[J]. J Cardiovasc Dev Dis,2019,6(3):26.
[12].Pu J,Mintz GS,Brilakis ES,et al. In vivo characterization of coronary plaques: novel findings from comparing greyscale and virtual histology intravascular ultrasound and near-infrared spectroscopy[J]. Eur Heart J,2012,33(3):372-383.
[13].Cho H,Kang SJ,Min HS,et al. Intravascular ultrasound-based deep learning for plaque characterization in coronary artery disease[J]. Atherosclerosis,2021,324:69-75.
[14].Wu X,Mintz GS,Xu K,et al. The relationship between attenuated plaque identified by intravascular ultrasound and no-reflow after stenting in acute myocardial infarction: the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial[J]. JACC Cardiovasc Interv,2011,4(5):495-502.
[15].Pu J,Mintz GS,Biro S,et al. Insights into echo-attenuated plaques,echolucent plaques,and plaques with spotty calcification: novel findings from comparisons among intravascular ultrasound,near-infrared spectroscopy,and pathological histology in 2,294 human coronary artery segments[J]. J Am Coll Cardiol,2014,63(21):2220-2233.
[16].Amano H,Wagatsuma K,Yamazaki J,et al. Virtual histology intravascular ultrasound analysis of attenuated plaque and ulcerated plaque detected by gray scale intravascular ultrasound and the relation between the plaque composition and slow flow/no reflow phenomenon during percutaneous coronary intervention[J]. J Interv Cardiol,2013,26(3):295-301.
[17].Endo M,Hibi K,Shimizu T,et al. Impact of ultrasound attenuation and plaque rupture as detected by intravascular ultrasound on the incidence of no-reflow phenomenon after percutaneous coronary intervention in ST-segment elevation myocardial infarction[J]. JACC Cardiovasc Interv,2010,3(5):540-549.
[18].王江友,鄢华.血管内超声在急性心肌梗死患者中的应用[J].中华老年心脑血管病杂志,2016,18(7):762-765.
[19].Lee T,Kakuta T,Yonetsu T,et al. Assessment of echo-attenuated plaque by optical coherence tomography and its impact on post-procedural creatine kinase-myocardial band elevation in elective stent implantation. JACC Cardiovasc Interv,2011,4(5):483-491.
[20].Jia R,Nie X,Li H,et al. Impact of attenuated plaques on TIMI grade flow and clinical outcomes of coronary artery disease patients:a systematic review and meta analysis[J]. J Thorac Dis,2016,8(3):527-536.
[21].Okura H,Kataoka T,Yoshiyama M,et al. Long-term prognostic impact of the attenuated plaque in patients with acute coronary syndrome[J]. Heart Vessels,2016,31(1):23-28.
[22].贾若飞,朱华刚,李响,等.血管内超声探测的衰减斑块对经皮冠状动脉介入治疗患者术中及术后的影响:12个月临床随访结果[J].中国介入心脏病学杂志,2016,24(5):266-271.
[23].耿学斌,李莉,王宏岭,等.衰减斑块对急性冠状动脉综合征患者冠状动脉介入治疗近远期临床结局的影响[J].中华超声影像学杂志,2015,24(6):492-495.
[24].Xu K,Mintz GS,Kubo T,et al. Long-term follow-up of attenuated plaques in patients with acute myocardial infarction:an intravascular ultrasound substudy of the HORIZONS-AMI trial [J]. Circ Cardiovasc Interv,2012,5(2):185-192.
[25].Hibi K,Kozuma K,Sonoda S,et al. A randomized study of distal filter protection versus conventional treatment during percutaneous coronary intervention in patients with attenuated plaque identified by intravascular ultrasound[J]. JACC Cardiovasc Interv,2018,11(16):1545-1555.
[26].Shiono Y,Kubo T,Tanaka A,et al. Impact of attenuated plaque as detected by intravascular ultrasound on the occurrence of microvascular obstruction after percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction[J]. JACC Cardiovasc Interv,2013,6(8):847-853.
[27].Shen ZJ,Brugaletta S,Garcia-Garcia HM,et al. Comparison of plaque prolapse in consecutive patients treated with Xience V and Taxus Liberte stents[J].?Int J Cardiovasc Imaging,2012,28(1):23-31.
[28].Qiu F,Mintz GS,Witzenbichler B,et al. Prevalence and clinical impact of tissue protrusion after stent implantation:an ADAPT-DES intravascular ultrasound substudy[J]. JACC Cardiovasc Interv,2016,9(14):1499-1507.
[29].Kobayashi N,Mintz GS,Witzenbichler B,et al. Prevalence,features,and prognostic importance of edge dissection after drug-eluting stent implantation:an ADAPT-DES intravascular ultrasound substudy[J]. Circ Cardiovasc Interv,2016,9(7):e003553.
[30].Wada H,Dohi T,Kasai T,et al. Culprit plaque characteristics in patients with sleep-disordered breathing undergoing percutaneous coronary interv ention:an intravascular ultrasound study[J]. J Am Heart Assoc,2018,7(19):e009826.
[31].Yun KH,Mintz GS,Witzenbichler B,et al. Relationship between platelet reactivity and culprit lesion morphology:an assessment from the aDAPT-DES intravascular ultrasound substudy[J]. JACC Cardiovasc Imaging,2016,9(7):849-854.
[32].Kitabata H,Loh JP,Pendyala LK,et al. Intravascular ultrasound analysis to determine the relationship between high-density lipoprotein cholesterol and lesion characteristics in patients with coronary artery disease[J]. J Interv Cardiol,2014,27(3):325-333.
[33].Hibi K,Kozuma K,Maejima N,et al. Long-term clinical outcomes after filter protection during percutaneous coronary intervention in patients with attenuated plaque-1-year follow up of the VAMPIRE 3 (Vacuum Aspiration Thrombus Reemoval 3) trial[J]. Circ J,2020,85(1):44-49.
[34].Munnur RK,Andrews J,Kataoka Y,et al. Quantitative and qualitative coronary plaque assessment using computed tomography coronary angiography:a comparison with intravascular ultrasound[J]. Heart Lung Circ,2020,29(6):883-893.
[35].Okutsu M,Horio T,Tanaka H,et al. Predictive performance of dual modality of computed tomography angiography and intravascular ultrasound for no-reflow phenomenon after percutaneous coronary stenting in stable coronary artery disease[J].?Heart Vessels,2018,33(10):1121-1128.
[36].Wu X,Maehara A,Mintz GS,et al. Virtual histology intravascular ultrasound analysis of non-culprit attenuated plaques detected by grayscale intravascular ultrasound in patients with acute coronary syndromes[J]. Am J Cardiol,2010,105(1):48-53.

相似文献/References:

[1]杜钧,佘强.冠心病抗炎治疗的临床研究进展[J].心血管病学进展,2016,(1):32.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.009]
 DU Jun,SHE Qiang.Clinical Research Progress of Anti-inflammatory Therapy of Coronary Heart Disease[J].Advances in Cardiovascular Diseases,2016,(4):32.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.009]
[2]努热曼古丽·阿布都克热木,马依彤.重度左心室收缩功能不全的冠心病患者血运重建治疗疗效及预后的评价[J].心血管病学进展,2016,(1):46.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.012]
 NUREMANGULI·Abudukeremu,MA Yitong.Evaluation of Efficacy and Prognosis of Revascularization Therapy on Patients with Coronary Heart Disease and Severe Left Ventricular Systolic Dysfunction[J].Advances in Cardiovascular Diseases,2016,(4):46.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.012]
[3]刘洋,综述,伍贵富,等.增强型体外反搏治疗冠心病的新机制[J].心血管病学进展,2016,(2):185.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.023]
 LIU Yang,WU Guifu.New Mechanism of Enhanced External Counterpulsation for Treatment of Coronary Artery Disease[J].Advances in Cardiovascular Diseases,2016,(4):185.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.023]
[4]杨洋,综述,沈比先,等.心脏核磁共振评估缺血性心脏病的应用价值[J].心血管病学进展,2016,(2):204.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.028]
 YANG Yang,SHEN Bixian.Value of Cardiac Magnetic Resonance Assessment of Ischemic Heart Disease[J].Advances in Cardiovascular Diseases,2016,(4):204.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.028]
[5]史敬,综述,马依彤,等.n-3多不饱和脂肪酸对心血管疾病的临床应用[J].心血管病学进展,2016,(3):278.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.016]
 SHI Jing,MA Yitong.Effects of n-3 Polyunsaturated Fatty Acids on Cardiovascular Disease[J].Advances in Cardiovascular Diseases,2016,(4):278.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.016]
[6]高柳,袁晋青.重复支架置入术治疗药物洗脱支架再狭窄的研究进展[J].心血管病学进展,2015,(5):555.[doi:10.3969/j.issn.1004-3934.2015.05.008]
 GAO Liu,YUAN Jingqing.Progress in Treatment for Drug-eluting Stent Restenosis by Re-implementation of Stents[J].Advances in Cardiovascular Diseases,2015,(4):555.[doi:10.3969/j.issn.1004-3934.2015.05.008]
[7]邓文政,邓平.MG53蛋白的研究进展[J].心血管病学进展,2015,(5):626.[doi:10.3969/j.issn.1004-3934.2015.05.027]
 DENG Wenzheng,DENG Ping.Research Progress of MG53[J].Advances in Cardiovascular Diseases,2015,(4):626.[doi:10.3969/j.issn.1004-3934.2015.05.027]
[8]陈静,李兴德.冠心病患者服药依从性的研究进展[J].心血管病学进展,2015,(6):728.[doi:10.3969/j.issn.1004-3934.2015.06.018]
 CHEN Jing,LI Xingde.Advances in Medication Adherence of Patients with Coronary Heart Disease[J].Advances in Cardiovascular Diseases,2015,(4):728.[doi:10.3969/j.issn.1004-3934.2015.06.018]
[9]姚雯,毛露,孙硕,等.心源性外泌体作为冠心病标志物和新靶点展望[J].心血管病学进展,2019,(6):844.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.002]
 YAO Wen,MAO Lu,SUN Shuo,et al.Exogenous Exosome as A New Marker and Target of Coronary Heart Disease[J].Advances in Cardiovascular Diseases,2019,(4):844.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.002]
[10]郭彩艳 靳春荣.腺苷药物在心血管疾病诊治中的应用进展[J].心血管病学进展,2019,(7):1011.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.012]
 GUO CaiyanJIN Chunrong.Progress in the Application of Adenosine Drugs in the Diagnosis and Treatment of Cardiovascular Diseases[J].Advances in Cardiovascular Diseases,2019,(4):1011.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.012]
[11]冯莉 林万鹏 郑丽婷 游紫阳 杨骄霞.经皮冠状动脉介入治疗后早期胸痛相关因素研究现状[J].心血管病学进展,2022,(11):1007.[doi:10.16806/j.cnki.issn.1004-3934.2022.11.010]
 FENG Li,LIN Wanpeng,ZHENG Liting,et al.Research Status of Related Factors of Early Chest Pain After?ercutaneous Coronary Intervention[J].Advances in Cardiovascular Diseases,2022,(4):1007.[doi:10.16806/j.cnki.issn.1004-3934.2022.11.010]

更新日期/Last Update: 2023-05-17