Yamaguchi Masao, Sugiyama Tomoyo, Hoshino Masahiro, Kanaji Yoshihisa, Hada Masahiro, Usui Eisuke, Yonetsu Taishi, Kakuta Tsunekazu
Department of Cardiology, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura City, Ibaraki 300-0028, Japan.
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo 113-8519, Japan.
Eur Heart J Case Rep. 2020 Jan 25;4(1):1-5. doi: 10.1093/ehjcr/ytz241. eCollection 2020 Feb.
Pathological studies have reported that patients with acute coronary syndrome (ACS) may have different plaque morphologies at culprit lesions, and one of the underlying mechanisms for ACS is plaque erosion. However, the morphological features of plaque erosion obtained by multiple intracoronary imaging modalities have not been fully elucidated.
We experienced two cases with ACS of culprit lesions exhibiting optical coherence tomography (OCT)-defined plaque erosion. Additional examinations using near-infrared spectroscopy (NIRS)-intravascular ultrasound and coronary angioscopy suggested the presence of two distinct phenotypes of plaque erosion. These two types of erosion differ in the extent of NIRS-derived lipid core burden and coronary angioscopy-derived luminal surface colour.
OCT-defined plaque erosion may not be the unique entity but have at least two distinct plaque morphologies, and NIRS and/or coronary angioscopy may provide incremental ability of discriminating these plaque phenotypes classified as plaque erosion by OCT.
病理研究报告称，急性冠状动脉综合征（ACS）患者的罪犯病变处可能有不同的斑块形态，而ACS的潜在机制之一是斑块侵蚀。然而，通过多种冠状动脉内成像方式获得的斑块侵蚀的形态学特征尚未完全阐明。
我们遇到了两例罪犯病变表现为光学相干断层扫描（OCT）定义的斑块侵蚀的ACS患者。使用近红外光谱（NIRS）-血管内超声和冠状动脉血管镜进行的进一步检查提示存在两种不同的斑块侵蚀表型。这两种类型的侵蚀在NIRS衍生的脂质核心负荷程度和冠状动脉血管镜衍生的管腔表面颜色方面有所不同。
OCT定义的斑块侵蚀可能不是单一实体，而是至少有两种不同的斑块形态，并且NIRS和/或冠状动脉血管镜可能提供额外的能力来区分这些被OCT分类为斑块侵蚀的斑块表型。
