Cor Vasa 2025, 67(1):6-15 | DOI: 10.33678/cor.2025.010

Near-infrared spectroscopy derived indexes as a potential predictor of plaque burden volume progression after unprotected left main coronary artery intervention

Martin Hudec^{a, b}, Jan Kaňovský^{a, b}, Vojtěch Brázdil^{a, b}, Martin Poloczek^a, Ivona Kask^a, Kristýna Hochmanová^a, Radka Smitalová^a, Otakar Boček^{a, b}, Petr Jeřábek^a, Roman Štípal^a, Simona Littnerová^c, Jiří Jarkovský^c, Klára Benešová^c, Petr Kala^{a, b}

^a Department of Internal Medicine and Cardiology, University Hospital Brno, the Czech Republic

^b Faculty of Medicine, Masaryk University, Brno, the Czech Republic

^c Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, the Czech Republic

Background: Coronary artery disease (CAD) is the leading cause of death worldwide, which has driven significant advances in the field of interventional cardiology. The combination of intravascular ultrasound (IVUS) and near-infrared light spectroscopy (NIRS) offers a detailed view of coronary artery morphology and plaque composition. This advanced imaging capability facilitates a more accurate assessment of CAD and enhances therapeutic strategies.

Objective: NIRS can detect and quantify lipid content in atherosclerotic plaque using the Lipid Core Burden Index (LCBI) and the Maximal Lipid Core Burden Index in a 4 mm segment (maxLCBI4mm). In this study, we examined the relationship between these indices and atherosclerotic plaque progression in the crucial area of the left main coronary artery (LM) during a follow-up period of 9 to 12 months after percutaneous coronary interventions (PCI).

Methods: A prospective, single-centre study was conducted involving 27 patients with significant left main stenosis who underwent IVUS-NIRS guided PCI. Serial assessments of the LCBI, maxLCBI4mm, and IVUS-derived plaque volume (PV) were performed at baseline, immediately post-PCI, and during follow-up at 9 to 12 months in 18 patients.

Results: The mean age of the study population was 72.7 years, with a predominance of male patients (88%). The average LCBI of the LM coronary artery before PCI was 128.9 ± 122.0, while maxLCBI4mm was 263.7 ± 172.0. The IVUS-measured PV post-PCI was 418.7 ± 203.3 mm³, increasing to 454.5 ± 209.4 mm³ at follow-up (p = 0.105). Analysis revealed no significant correlation between the difference in PV and baseline LCBI or maxLCBI4mm, with p-values of 0.626 and 0.786, respectively.

Conclusion: This study found no significant association between initial LCBI and maxLCBI4mm segment values and subsequent changes in PV in the left main coronary artery. However, correlation graphs indicate a trend toward decreased PV in patients with high initial LCBI and maxLCBI4mm.

Keywords: Intravascular imaging, IVUS, LCBI, Left main

Received: November 26, 2024; Revised: December 27, 2024; Accepted: January 19, 2025; Prepublished online: June 2, 2012; Published: March 1, 2025  Show citation