Otto Sylvia, Nitsche Kristina, Jung Christian, Kryvanos Aleh, Zhylka Andrey, Heitkamp Kerstin, Gutiérrez-Chico Juan-Luis, Goebel Björn, Schulze P Christian, Figulla Hans R, Poerner Tudor C
Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena Friedrich-Schiller-University Jena, Am Klinikum 1, 07747, Jena, Germany.
Department of Cardiology, Pulmonology, University, Duesseldorf, Medical Faculty and Vascular Diseases, Düsseldorf, Germany.
BMC Cardiovasc Disord. 2017 Apr 26;17(1):103. doi: 10.1186/s12872-017-0534-1.
Endothelial progenitor cells (EPC) are involved in neovascularization and endothelial integrity. They might be protective in atherosclerosis. Optical coherence tomography (OCT) is a precise intracoronary imaging modality that allows assessment of subintimal plaque development. We evaluated the influence of EPC on coronary plaque burden in stable disease and implemented a novel computational plaque analysis algorithm using OCT.
Forty-three patients (69.8% males, 69.6 ± 7.7 years) were investigated by OCT during re-angiography 6 months after elective stent implantation. Different subpopulations of EPCs were identified by flow cytometry according to their co-expression of antigens (CD34+, CD133+, kinase domain receptor, KDR+). An algorithm was applied to calculate the underlying total plaque burden of the stented segments from OCT images. Plaque morphology was assessed according to international consensus in OCT imaging.
A cumulative sub-strut plaque volume of 10.87 ± 12.7 mm and a sub-stent plaque area of 16.23 ± 17.0 mm were found within the stented vessel segments with no significant differences between different stent types. All EPC subpopulations (mean of EPC levels: CD34+/CD133+: 2.66 ± 2.0%; CD34+/KDR+: 7.50 ± 5.0%; CD34+/CD133+/KDR+: 1.12 ± 1.0%) inversely correlated with the identified underlying total plaque volume and plaque area (p ≤ 0.012).
This novel analysis algorithm allows for the first time comprehensive quantification of coronary plaque burden by OCT and illustration as spread out vessel charts. Increased EPC levels are associated with less sub-stent coronary plaque burden which adds to previous findings of their protective role in atherosclerosis.
内皮祖细胞（EPC）参与新生血管形成和内皮完整性维持。它们可能对动脉粥样硬化具有保护作用。光学相干断层扫描（OCT）是一种精确的冠状动脉内成像方式，可用于评估内膜下斑块的发展。我们评估了EPC对稳定型疾病中冠状动脉斑块负荷的影响，并使用OCT实施了一种新型的计算斑块分析算法。
43例患者（男性占69.8%，年龄69.6±7.7岁）在择期支架植入6个月后的再次血管造影期间接受了OCT检查。根据抗原共表达情况（CD34+、CD133+、激酶结构域受体、KDR+），通过流式细胞术鉴定不同亚群的EPC。应用一种算法从OCT图像计算支架段的潜在总斑块负荷。根据OCT成像的国际共识评估斑块形态。
在支架血管段内发现累积支架小梁下斑块体积为10.87±12.7mm³，支架内斑块面积为16.23±17.0mm²，不同支架类型之间无显著差异。所有EPC亚群（EPC水平均值：CD34+/CD133+：2.66±2.0%；CD34+/KDR+：7.50±5.0%；CD34+/CD133+/KDR+：1.12±1.0%）与确定的潜在总斑块体积和斑块面积呈负相关（p≤(0.012)）。
这种新型分析算法首次实现了通过OCT对冠状动脉斑块负荷进行全面量化，并以展开的血管图形式呈现。EPC水平升高与支架内冠状动脉斑块负荷减轻相关，这进一步支持了它们在动脉粥样硬化中具有保护作用的先前研究结果。
