Schmermund Axel, Rodermann Jörg, Erbel Raimund
Department of Cardiology, University Clinic Essen, Germany.
Herz. 2003 Sep;28(6):505-12. doi: 10.1007/s00059-003-2495-7.
Arteriosclerosis is an inflammatory disease. Inflammatory processes play a role in the initiation of plaque development and the early stages of the disease as well as in complex plaques and complications such as intraarterial thrombosis. A method to detect inflammation in coronary arteries has the potential to characterize both local and systemic activation of arteriosclerotic plaque disease. It could help to define in more detail what constitutes a vulnerable plaque or vulnerable vessel and thus improve the prediction of acute coronary syndromes. Intracoronary thermography records a cardinal sign of inflammation. Heat is probably produced by (activated) macrophages. Experimental work has suggested that thermal heterogeneity is present in arteriosclerotic plaques and that increased temperature is found at the site of inflammatory cellular-macrophage-infiltration. Preliminary experience in patients undergoing coronary angiography has demonstrated that it is safe and feasible to perform intracoronary thermography using various systems. A graded relationship between thermal heterogeneity and clinical symptoms has been reported, with the greatest temperature elevation in acute myocardial infarction. Increases in thermal heterogeneity appeared to be associated with a comparably unfavorable long-term prognosis. Intracoronary thermography has the potential to provide insights into location and extent of inflammation as well as the prognostic consequences. Currently, this novel method and the underlying concepts are extensively evaluated.
动脉粥样硬化是一种炎症性疾病。炎症过程在斑块形成的起始阶段、疾病的早期阶段以及复杂斑块和并发症（如动脉内血栓形成）中均发挥作用。一种检测冠状动脉炎症的方法有可能对动脉粥样硬化斑块疾病的局部和全身激活情况进行表征。它有助于更详细地确定什么构成易损斑块或易损血管，从而改善对急性冠状动脉综合征的预测。冠状动脉内温度记录法记录了炎症的一个主要体征。热量可能由（活化的）巨噬细胞产生。实验研究表明，动脉粥样硬化斑块中存在热不均一性，且在炎症细胞（巨噬细胞）浸润部位温度会升高。接受冠状动脉造影术患者的初步经验表明，使用各种系统进行冠状动脉内温度记录法是安全可行的。据报道，热不均一性与临床症状之间存在分级关系，急性心肌梗死时温度升高最为明显。热不均一性的增加似乎与相对不利的长期预后相关。冠状动脉内温度记录法有可能深入了解炎症的位置和程度以及预后情况。目前，这种新方法及其基本概念正在得到广泛评估。
