Guiding treatment and study of atherosclerotic cardiovascular disease

We research the development of an intravascular bi-modal technology for diagnosis of arterial wall pathologies including rupture-prone (vulnerable) atherosclerotic plaques. Our goal is to optimize, construct and test a unique clinically-compatible system that combines fast, time-resolved fluorescence spectroscopy (TRFS) to dynamically evaluate atherosclerotic plaque composition under pull-back motion, with intravascular ultrasound (IVUS) that allows for both visual reconstruction of plaque microanatomy and guidance of TRFS measurements. The resulting system will enable detection and monitoring of biochemical, functional and structural features of atherosclerotic lesions with clinical relevance (e.g. predictive of plaque rupture).

This bi-modal intravascular technique targets advancement of new paradigms for diagnosis and management of atherosclerotic cardiovascular disease that affects >80 million individuals in the US and represents the leading cause of death (>830,000/year). The proposed approach of integrating TRFS with IVUS should improve the diagnostic ability of IVUS, the most widely used intravascular imaging technique in interventional cardiology. Examples of important applications for this bimodal technology in patients who are candidates for transluminal interventional procedures include: a) If a plaque is more accurately classified with TRFS-IVUS and the risk of rupture can be predicted, patients could be identified and treated prior to symptoms or rupture. b) If the TRFS- IVUS system allows better understanding of atherosclerotic plaque pathologies it could be used to predict which patients would benefit from therapy. c) In the large number of patients who undergo repeat catheterization, it should allow the clinician to monitor the effects of various pharmacologic (e.g lipid lowering drugs) interventions.

Clinical collaborators: Jeffrey Southard , William Ferrier

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