基于双模态光声-超声成像的冠状动脉易损斑块脂质核心体积定量及其对急性心血管事件的预测价值研究OA

Objective:The purpose of this study is to explore the precise quantitative ability of dual-mode photoacoustic ultrasound imaging technology for lipid core volume(LCV)in vulnerable plaques of coronary arteries,and its clinical value in predicting acute cardiovascular events.Methods:A retrospective study was conducted on 137 patients who underwent coronary intervention treatment in our hospital from January 2022 to June 2024.All patients completed dual-mode photoacoustic ultrasound imaging before surgery and collected complete clinical data and cardiovascular event follow-up data for at least 6 months after surgery.The Endra Nexus 128 system was used to capture images of coronary artery plaques,and the accompanying software was used to analyze lipid core volume.Divided into a large volume group(LCV ≥65 mm3,n=66)and a small volume group(LCV＜65 mm3,n=71)based on clinical operability of 65 mm3,the incidence of acute cardiovascular events was compared between the two groups of patients.Results:The average LCV was 68.57±24.63 mm3.The LCV(88.91±23.46 mm3),maximum lipid core area(16.68±4.82 mm2),and lipid core length(37.29±10.15 mm)of the large volume lipid core plaque group(LCV ≥65 mm3,n=66)were significantly higher than those of the small volume lipid core plaque group(LCV＜65 mm3,n=71)(P＜0.05).The incidence of Major Adverse Cardiovascular Events(MACE)was significantly higher in the group with large volume lipid core plaques(P＜0.05),and the risk of acute myocardial infarction was particularly prominent.LCV is positively correlated with LDL-C(r=0.412),hs-CRP(r=0.387),and plaque length(r=0.453),and negatively correlated with LVEF(r=-0.226)(P＜0.05).Cox regression confirmed that LCV ≥65 mm3 is an independent predictor of MACE(HR=2.56,95％CI:1.21～5.41);The ROC curve shows that the AUC of LCV for predicting MACE is 0.908(optimal cutoff value of 63.01 mm3,sensitivity of 88％,specificity of 83％).The truncated value verifies the rationality of the 65mm3 grouping,and the trend and difference of the two indicators are no different from the previous grouping,indicating a better verification effect.Conclusion:Dual modal photoacoustic ultrasound imaging can quantitatively evaluate the lipid core volume of coronary artery plaques with high resolution and minimally invasive techniques.The larger the lipid core volume,the higher the risk of acute cardiovascular events.This technology is expected to become an important tool for early identification of high-risk coronary artery lesions,assessment of plaque stability,and guidance for clinical intervention.