Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture
Abstract Objective Risk stratification plays a critical role in patients with asymptomatic carotid atherosclerotic stenosis. Heavy macrophage infiltration (HMC) is an important factor of plaque destabilization. However, in vivo imaging technologies and screening criteria for HMC remain limited. We a...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51923 |
| _version_ | 1797389839942811648 |
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| author | Xuan Shi Tao Tao Yi Wang Yunfei Han Xiaohui Xu Qin Yin Fang Wang Rui Liu Xinfeng Liu |
| author_facet | Xuan Shi Tao Tao Yi Wang Yunfei Han Xiaohui Xu Qin Yin Fang Wang Rui Liu Xinfeng Liu |
| author_sort | Xuan Shi |
| collection | DOAJ |
| description | Abstract Objective Risk stratification plays a critical role in patients with asymptomatic carotid atherosclerotic stenosis. Heavy macrophage infiltration (HMC) is an important factor of plaque destabilization. However, in vivo imaging technologies and screening criteria for HMC remain limited. We aimed to (i) introduce algorithms for in vivo detection of macrophage infiltrations using optical coherence tomography (OCT) and (ii) to investigate the threshold of HMC and its association with plaque vulnerability. Methods Ex vivo OCT images were co‐registered with histopathology in 282 cross‐sectional pairs from 19 carotid endarterectomy specimens. Of these, 197 randomly selected pairs were employed to define the parameters, and the remaining 85 pairs were used to evaluate the accuracy of the OCT‐based algorithm in detecting macrophage infiltrations. Clinical analysis included 93 patients receiving carotid OCT evaluation. The prevalence and burden of macrophage infiltration were analyzed. Multivariable and subgroup analysis were performed to investigate the association between HMC and plaque rupture. Results The sensitivity and specificity of algorithm for detecting macrophage infiltration were 88.0% and 74.9%, respectively. Of 93 clinical patients, ruptured plaques exhibited higher prevalence of macrophage infiltration than nonruptured plaques (83.7% [36/43] vs 32.0% [16/50], p < 0.001). HMC was identified when the macrophage index was greater than 60.2 (sensitivity = 74.4%, specificity = 84.0%). Multivariable analysis showed that HMC and multiple calcification were independent risk factors for non‐lipid‐rich plaque rupture. Interpretation This study provides a novel approach and screening criteria for HMC, which might be valuable for atherosclerotic risk stratification. |
| first_indexed | 2024-03-08T23:01:49Z |
| format | Article |
| id | doaj.art-c8c9c891f74c4b0592964fe4af79f088 |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-03-08T23:01:49Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-c8c9c891f74c4b0592964fe4af79f0882023-12-15T16:39:24ZengWileyAnnals of Clinical and Translational Neurology2328-95032023-12-0110122334234610.1002/acn3.51923Heavy macrophage infiltration identified by optical coherence tomography relates to plaque ruptureXuan Shi0Tao Tao1Yi Wang2Yunfei Han3Xiaohui Xu4Qin Yin5Fang Wang6Rui Liu7Xinfeng Liu8Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaDepartment of Neurosurgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaDepartment of Neurosurgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaDepartment of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaDepartment of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaDepartment of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaDepartment of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaDepartment of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaDepartment of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School Nanjing University Nanjing ChinaAbstract Objective Risk stratification plays a critical role in patients with asymptomatic carotid atherosclerotic stenosis. Heavy macrophage infiltration (HMC) is an important factor of plaque destabilization. However, in vivo imaging technologies and screening criteria for HMC remain limited. We aimed to (i) introduce algorithms for in vivo detection of macrophage infiltrations using optical coherence tomography (OCT) and (ii) to investigate the threshold of HMC and its association with plaque vulnerability. Methods Ex vivo OCT images were co‐registered with histopathology in 282 cross‐sectional pairs from 19 carotid endarterectomy specimens. Of these, 197 randomly selected pairs were employed to define the parameters, and the remaining 85 pairs were used to evaluate the accuracy of the OCT‐based algorithm in detecting macrophage infiltrations. Clinical analysis included 93 patients receiving carotid OCT evaluation. The prevalence and burden of macrophage infiltration were analyzed. Multivariable and subgroup analysis were performed to investigate the association between HMC and plaque rupture. Results The sensitivity and specificity of algorithm for detecting macrophage infiltration were 88.0% and 74.9%, respectively. Of 93 clinical patients, ruptured plaques exhibited higher prevalence of macrophage infiltration than nonruptured plaques (83.7% [36/43] vs 32.0% [16/50], p < 0.001). HMC was identified when the macrophage index was greater than 60.2 (sensitivity = 74.4%, specificity = 84.0%). Multivariable analysis showed that HMC and multiple calcification were independent risk factors for non‐lipid‐rich plaque rupture. Interpretation This study provides a novel approach and screening criteria for HMC, which might be valuable for atherosclerotic risk stratification.https://doi.org/10.1002/acn3.51923 |
| spellingShingle | Xuan Shi Tao Tao Yi Wang Yunfei Han Xiaohui Xu Qin Yin Fang Wang Rui Liu Xinfeng Liu Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture Annals of Clinical and Translational Neurology |
| title | Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture |
| title_full | Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture |
| title_fullStr | Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture |
| title_full_unstemmed | Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture |
| title_short | Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture |
| title_sort | heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture |
| url | https://doi.org/10.1002/acn3.51923 |
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