Okinaka Memorial Institute for Medical Research,Tokyo, Japan.
Curr Atheroscler Rep. 2012 Apr;14(2):175-85. doi: 10.1007/s11883-012-0234-3.
New imaging techniques have been used to examine surrogate markers of atherosclerotic burden to determine the effects of pharmacologic intervention. In this review, we discuss the role of intravascular ultrasound (IVUS) in the determination of progression and regression of coronary artery disease. Several methodologic issues are discussed (selection of segments to analyze, measurement error, high drop out rate, and optimal IVUS variables). Usefulness of new IVUS-derived variables (plaque composition by radiofrequency analysis, deformability by palpography, and endothelial shear stress by three-dimensional coronary anatomy reconstructed from IVUS and angiography) will be determined. Based on comparisons between IVUS and clinical studies, IVUS variables seem to be a valid surrogate in studies using atorvastatin in patients with dyslipidemia. It remains unclear whether IVUS variables are valid surrogates for other drugs/diseases. As such, further studies are needed to determine whether IVUS can serve as an efficient surrogate for clinical events in coronary disease trials.
新的成像技术已被用于检查动脉粥样硬化负担的替代标志物，以确定药物干预的效果。在这篇综述中，我们讨论了血管内超声（IVUS）在确定冠状动脉疾病进展和消退中的作用。讨论了几个方法学问题（要分析的节段选择、测量误差、高脱落率和最佳 IVUS 变量）。将确定新的基于 IVUS 的变量（通过射频分析的斑块组成、通过触诊的可变形性以及通过从 IVUS 和血管造影重建的三维冠状动脉解剖结构的内皮剪切应力）的有用性。基于 IVUS 与临床研究的比较，IVUS 变量似乎是在血脂异常患者中使用阿托伐他汀的研究中的有效替代指标。目前尚不清楚 IVUS 变量是否是其他药物/疾病的有效替代指标。因此，需要进一步的研究来确定 IVUS 是否可以作为冠状动脉疾病试验中临床事件的有效替代指标。
