Skip to main content
SpringerLink
Log in

Finding the Hot Plaque: Intravascular Thermography

  • Chapter
  • First Online:
Imaging Coronary Atherosclerosis

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 1177 Accesses

Abstract

Atherosclerosis and its cardiovascular complications remain the leading cause of death in developed countries. The recognition of the vulnerable plaque (VP) as the substrate of acute coronary events has led to new challenging paths in imaging modalities, invasive or not. One of the main characteristics of VP is inflammation. Intravascular thermography (IVT) was introduced as a technique for the functional evaluation of the atherosclerotic plaque, based on the principle that temperature is a significant marker of inflammatory activity. Temperature measurement of the atheromatic plaques was proved feasible and safe in vivo, depicting good correlation with clinical outcomes and histological findings in clinical trials. However, the limitations that have arisen narrowed the clinical application of this method. Future technological achievements, including the combination of IVT with other imaging modalities or the introduction of novel noninvasive methods, will hopefully lead to expedient identification of the VP.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, Hailpern SM, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O’Donnell C, Roger V, Sorlie P, Steinberger J, Thom T, Wilson M, Hong Y. Heart disease and stroke statistics–2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008;117(4):e25–146.

    Article  PubMed  Google Scholar 

  2. Honda Y, Fitzgerald PJ. Frontiers in intravascular imaging technologies. Circulation. 2008;117(15):2024–37.

    Article  PubMed  Google Scholar 

  3. Ross R. Atherosclerosis–an inflammatory disease. N Engl J Med. 1999;340(2):115–26.

    Article  CAS  PubMed  Google Scholar 

  4. Libby P, Ridker PM, Hansson GK. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol. 2009;54(23):2129–38.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105(9):1135–43.

    Article  CAS  PubMed  Google Scholar 

  6. Schoenhagen P. Plaque temperature, arterial remodeling, and inflammation: understanding “hot-spots” in the coronary arteries. J Am Coll Cardiol. 2007;49(23):2272–3.

    Article  PubMed  Google Scholar 

  7. Naghavi M, Falk E, Hecht HS, Jamieson MJ, Kaul S, Berman D, Fayad Z, Budoff MJ, Rumberger J, Naqvi TZ, Shaw LJ, Faergeman O, Cohn J, Bahr R, Koenig W, Demirovic J, Arking D, Herrera VL, Badimon J, Goldstein JA, Rudy Y, Airaksinen J, Schwartz RS, Riley WA, Mendes RA, Douglas P, Shah PK. From vulnerable plaque to vulnerable patient–Part III: executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report. Am J Cardiol. 2006;98(2A):2H–15.

    Article  PubMed  Google Scholar 

  8. Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, Mehran R, McPherson J, Farhat N, Marso SP, Parise H, Templin B, White R, Zhang Z, Serruys PW. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364(3):226–35.

    Article  CAS  PubMed  Google Scholar 

  9. Toutouzas K, Synetos A, Nikolaou C, Tsiamis E, Tousoulis D, Stefanadis C. Matrix metalloproteinases and vulnerable atheromatous plaque. Curr Top Med Chem. 2012;12(10):1166–80.

    Article  CAS  PubMed  Google Scholar 

  10. Heinle H. Metabolite concentration gradients in the arterial wall of experimental atherosclerosis. Exp Mol Pathol. 1987;46(3):312–20.

    Article  CAS  PubMed  Google Scholar 

  11. Tenaglia AN, Peters KG, Sketch Jr MH, Annex BH. Neovascularization in atherectomy specimens from patients with unstable angina: implications for pathogenesis of unstable angina. Am Heart J. 1998;135(1):10–4.

    Article  CAS  PubMed  Google Scholar 

  12. Madjid M, Willerson JT, Casscells SW. Intracoronary thermography for detection of high-risk vulnerable plaques. J Am Coll Cardiol. 2006;47(8 suppl):C80–5.

    Article  PubMed  Google Scholar 

  13. Kockx MM, Seye C, De Meyer GR, Knaapen MW. Decreased apoptosis and tissue factor expression after lipid lowering. Circulation. 2000;102(13):E99.

    Article  CAS  PubMed  Google Scholar 

  14. Kockx MM, De Meyer GR, Buyssens N, Knaapen MW, Bult H, Herman AG. Cell composition, replication, and apoptosis in atherosclerotic plaques after 6 months of cholesterol withdrawal. Circ Res. 1998;83(4):378–87.

    Article  CAS  PubMed  Google Scholar 

  15. Casscells W, Hathorn B, David M, Krabach T, Vaughn WK, McAllister HA, Bearman G, Willerson JT. Thermal detection of cellular infiltrates in living atherosclerotic plaques: possible implications for plaque rupture and thrombosis. Lancet. 1996;347(9013):1447–51.

    Article  CAS  PubMed  Google Scholar 

  16. Toutouzas K, Spanos V, Ribichini F. A correlation of coronary plaque temperature with inflammatory markers obtained from atherectomy specimens in humans. Am J Cardiol. 2003;92:476.

    Google Scholar 

  17. Madjid M, Naghavi M, Malik BA, Litovsky S, Willerson JT, Casscells W. Thermal detection of vulnerable plaque. Am J Cardiol. 2002;90(10C):36L–9L.

    Article  PubMed  Google Scholar 

  18. Naghavi M, John R, Naguib S, Siadaty MS, Grasu R, Kurian KC, van Winkle WB, Soller B, Litovsky S, Madjid M, Willerson JT, Casscells W. pH Heterogeneity of human and rabbit atherosclerotic plaques; a new insight into detection of vulnerable plaque. Atherosclerosis. 2002;164(1):27–35.

    Article  CAS  PubMed  Google Scholar 

  19. Naghavi M, Madjid M, Gul K, Siadaty MS, Litovsky S, Willerson JT, Casscells SW. Thermography basket catheter: in vivo measurement of the temperature of atherosclerotic plaques for detection of vulnerable plaques. Catheter Cardiovasc Interv. 2003;59(1):52–9.

    Article  PubMed  Google Scholar 

  20. Verheye S, De Meyer GR, Van Langenhove G, Knaapen MW, Kockx MM. In vivo temperature heterogeneity of atherosclerotic plaques is determined by plaque composition. Circulation. 2002;105(13):1596–601.

    Article  PubMed  Google Scholar 

  21. Krams R, Verheye S, van Damme LC, Tempel D, Mousavi Gourabi B, Boersma E, Kockx MM, Knaapen MW, Strijder C, van Langenhove G, Pasterkamp G, van der Steen AF, Serruys PW. In vivo temperature heterogeneity is associated with plaque regions of increased MMP-9 activity. Eur Heart J. 2005;26(20):2200–5.

    Article  CAS  PubMed  Google Scholar 

  22. Stefanadis C, Diamantopoulos L, Vlachopoulos C, Tsiamis E, Dernellis J, Toutouzas K, Stefanadi E, Toutouzas P. Thermal heterogeneity within human atherosclerotic coronary arteries detected in vivo: a new method of detection by application of a special thermography catheter. Circulation. 1999;99(15):1965–71.

    Article  CAS  PubMed  Google Scholar 

  23. Toutouzas K, Vaina S, Tsiamis E, Vavuranakis M, Mitropoulos J, Bosinakou E, Toutouzas P, Stefanadis C. Detection of increased temperature of the culprit lesion after recent myocardial infarction: the favorable effect of statins. Am Heart J. 2004;148(5):783–8.

    Article  PubMed  Google Scholar 

  24. Schmermund A, Rodermann J, Erbel R. Intracoronary thermography. Herz. 2003;28(6):505–12.

    Article  PubMed  Google Scholar 

  25. Toutouzas K, Markou V, Drakopoulou M, Mitropoulos I, Tsiamis E, Vavuranakis M, Vaina S, Stefanadis C. Increased heat generation from atherosclerotic plaques in patients with type 2 diabetes: an increased local inflammatory activation. Diabetes Care. 2005;28(7):1656–61.

    Article  PubMed  Google Scholar 

  26. Toutouzas K, Tsiamis E, Drakopoulou M, Synetos A, Karampelas J, Riga M, Tsioufis C, Tousoulis D, Stefanadi E, Vlasis C, Stefanadis C. Impact of type 2 diabetes mellitus on diffuse inflammatory activation of de novo atheromatous lesions: implications for systemic inflammation. Diabetes Metab. 2009;35(4):299–304.

    Article  CAS  PubMed  Google Scholar 

  27. Toutouzas K, Markou V, Drakopoulou M, Mitropoulos I, Tsiamis E, Stefanadis C. Patients with type two diabetes mellitus: increased local inflammatory activation in culprit atheromatous plaques. Hellenic J Cardiol. 2005;46(4):283–8.

    PubMed  Google Scholar 

  28. Stefanadis C, Toutouzas K, Tsiamis E, Stratos C, Vavuranakis M, Kallikazaros I, Panagiotakos D, Toutouzas P. Increased local temperature in human coronary atherosclerotic plaques: an independent predictor of clinical outcome in patients undergoing a percutaneous coronary intervention. J Am Coll Cardiol. 2001;37(5):1277–83.

    Article  CAS  PubMed  Google Scholar 

  29. Libby P. Lipid-lowering therapy stabilizes plaque, reduces events by limiting inflammation. Am J Manag Care. 2002;Suppl 1:4.

    Google Scholar 

  30. Stefanadis C, Toutouzas K, Vavuranakis M, Tsiamis E, Tousoulis D, Panagiotakos DB, Vaina S, Pitsavos C, Toutouzas P. Statin treatment is associated with reduced thermal heterogeneity in human atherosclerotic plaques. Eur Heart J. 2002;23(21):1664–9.

    Article  CAS  PubMed  Google Scholar 

  31. Stefanadis C, Diamantopoulos L, Dernellis J, Economou E, Tsiamis E, Toutouzas K, Vlachopoulos C, Toutouzas P. Heat production of atherosclerotic plaques and inflammation assessed by the acute phase proteins in acute coronary syndromes. J Mol Cell Cardiol. 2000;32(1):43–52.

    Article  CAS  PubMed  Google Scholar 

  32. Cuisset T, Beauloye C, Melikian N, Hamilos M, Sarma J, Sarno G, Naslund M, Smith L, Van de Vosse F, Pijls NH, De Bruyne B. In vitro and in vivo studies on thermistor-based intracoronary temperature measurements: effect of pressure and flow. Catheter Cardiovasc Interv. 2009;73(2):224–30.

    Article  PubMed  Google Scholar 

  33. Wainstein M, Costa M, Ribeiro J, Zago A, Rogers C. Vulnerable plaque detection by temperature heterogeneity measured with a guidewire system: clinical, intravascular ultrasound and histopathologic correlates. J Invasive Cardiol. 2007;19(2):49–54.

    PubMed  Google Scholar 

  34. Toutouzas K, Synetos A, Stefanadi E, Vaina S, Markou V, Vavuranakis M, Tsiamis E, Tousoulis D, Stefanadis C. Correlation between morphologic characteristics and local temperature differences in culprit lesions of patients with symptomatic coronary artery disease. J Am Coll Cardiol. 2007;49(23):2264–71.

    Article  PubMed  Google Scholar 

  35. Stefanadis C, Toutouzas K, Tsiamis E, Mitropoulos I, Tsioufis C, Kallikazaros I, Pitsavos C, Toutouzas P. Thermal heterogeneity in stable human coronary atherosclerotic plaques is underestimated in vivo: the “cooling effect” of blood flow. J Am Coll Cardiol. 2003;41(3):403–8.

    Article  PubMed  Google Scholar 

  36. Belardi JA, Albertal M, Cura FA, Mendiz O, Balino PP, Padilla LT, Lauer M, Korotko J, O’Neill W. Intravascular thermographic assessment in human coronary atherosclerotic plaques by a novel flow-occluding sensing catheter: a safety and feasibility study. J Invasive Cardiol. 2005;17(12):663–6.

    PubMed  Google Scholar 

  37. ten Have AG, Draaijers EB, Gijsen FJ, Wentzel JJ, Slager CJ, Serruys PW, van der Steen AF. Influence of catheter design on lumen wall temperature distribution in intracoronary thermography. J Biomech. 2007;40(2):281–8.

    Article  PubMed  Google Scholar 

  38. Worthley S, Farouque MO, Worthley M, Baldi M, Chew D, Meredith I. The RADI PressureWire high-sensitivity thermistor and culprit lesion temperature in patients with acute coronary syndromes. J Invasive Cardiol. 2006;18(11):528–31.

    PubMed  Google Scholar 

  39. Stefanadis C, Toutouzas K, Vavuranakis M, Tsiamis E, Vaina S, Toutouzas P. New balloon-thermography catheter for in vivo temperature measurements in human coronary atherosclerotic plaques: a novel approach for thermography? Catheter Cardiovasc Interv. 2003;58(3):344–50.

    Article  PubMed  Google Scholar 

  40. Toutouzas K, Grassos H, Synetos A, Drakopoulou M, Tsiamis E, Moldovan C, Agrogiannis G, Patsouris E, Siores E, Stefanadis C. A new non-invasive method for detection of local inflammation in atherosclerotic plaques: experimental application of microwave radiometry. Atherosclerosis. 2011;215(1):82–9.

    Article  CAS  PubMed  Google Scholar 

  41. Toutouzas K, Grassos C, Drakopoulou M, Synetos A, Tsiamis E, Aggeli C, Stathogiannis K, Klettas D, Kavantzas N, Agrogiannis G, Patsouris E, Klonaris C, Liasis N, Tousoulis D, Siores E, Stefanadis C. First in vivo application of microwave radiometry in human carotids: a new noninvasive method for detection of local inflammatory activation. J Am Coll Cardiol. 2012;59(18):1645–53.

    Article  PubMed  Google Scholar 

  42. Webster M, Stewart J, Ruygrok P. Intracoronary thermography with a multiple thermocouple catheter: initial human experience. Am J Cardiol. 2002;90:24H.

    Article  Google Scholar 

  43. Stefanadis C, Tsiamis E, Vaina S, Toutouzas K, Boudoulas H, Gialafos J, Toutouzas P. Temperature of blood in the coronary sinus and right atrium in patients with and without coronary artery disease. Am J Cardiol. 2004;93(2):207–10.

    Article  PubMed  Google Scholar 

  44. Dudek D, Rzeszutko L, Legutko J, Wizimirski M, Chyrchel M, Witanek B, Dubiel JS. High-risk coronary artery plaques diagnosed by intracoronary thermography. Kardiol Pol. 2005;62(4):383–9.

    PubMed  Google Scholar 

  45. Toutouzas K, Drakopoulou M, Markou V, Stougianos P, Tsiamis E, Tousoulis D, Stefanadis C. Increased coronary sinus blood temperature: correlation with systemic inflammation. Eur J Clin Invest. 2006;36(4):218–23.

    Article  CAS  PubMed  Google Scholar 

  46. Toutouzas K, Drakopoulou M, Mitropoulos J, Tsiamis E, Vaina S, Vavuranakis M, Markou V, Bosinakou E, Stefanadis C. Elevated plaque temperature in non-culprit de novo atheromatous lesions of patients with acute coronary syndromes. J Am Coll Cardiol. 2006;47(2):301–6.

    Article  PubMed  Google Scholar 

  47. Rzeszutko L, Legutko J, Kaluza GL, Wizimirski M, Richter A, Chyrchel M, Heba G, Dubiel JS, Dudek D. Assessment of culprit plaque temperature by intracoronary thermography appears inconclusive in patients with acute coronary syndromes. Arterioscler Thromb Vasc Biol. 2006;26(8):1889–94.

    Article  CAS  PubMed  Google Scholar 

  48. Takumi T, Lee S, Hamasaki S, Toyonaga K, Kanda D, Kusumoto K, Toda H, Takenaka T, Miyata M, Anan R, Otsuji Y, Tei C. Limitation of angiography to identify the culprit plaque in acute myocardial infarction with coronary total occlusion utility of coronary plaque temperature measurement to identify the culprit plaque. J Am Coll Cardiol. 2007;50(23):2197–203.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. First Department of Cardiology, Athens Medical School, Hippokration Hospital, 24, Karaoli and Dimitriou Street, Holargos, Athens, 15562, Greece

    Konstantinos Toutouzas MD

  2. First Department of Cardiology, Athens Medical School, Hippokration Hospital, 7, Tainarou Street, Peiraeus, 18453, Greece

    Archontoula Michelongona MD

  3. First Department of Cardiology, Athens Medical School, Hippokration Hospital, 4, Amiklon Street, Halandri, 15231, Greece

    Maria Drakopoulou MD

  4. First Department of Cardiology, Athens Medical School, Hippokration Hospital, 9 Tepeleniou Street, Paleo Psychico, 15454, Greece

    Christodoulos Stefanadis MD

Authors
  1. Konstantinos Toutouzas MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Archontoula Michelongona MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Drakopoulou MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christodoulos Stefanadis MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Konstantinos Toutouzas MD .

Editor information

Editors and Affiliations

  1. South Australian Health and Medical Research Institute, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia

    Stephen J. Nicholls

  2. Project Development, C5Research, Cleveland, Ohio, USA

    Tim Crowe

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Toutouzas, K., Michelongona, A., Drakopoulou, M., Stefanadis, C. (2014). Finding the Hot Plaque: Intravascular Thermography. In: Nicholls, S., Crowe, T. (eds) Imaging Coronary Atherosclerosis. Contemporary Cardiology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0572-0_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-0572-0_9

  • Published:

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-0571-3

  • Online ISBN: 978-1-4939-0572-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation