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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:1889.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Assessment of Culprit Plaque Temperature by Intracoronary Thermography Appears Inconclusive in Patients With Acute Coronary Syndromes

ukasz Rzeszutko; Jacek Legutko; Grzegorz L. Kaua; Marcin Wizimirski; Angela Richter; Micha Chyrchel; Grzegorz Heba; Jacek S. Dubiel; Dariusz Dudek

From II Department of Cardiology (L.R., J.L., M.W., M.C., G.H., J.S.D., D.D.), Institute of Cardiology, Jagiellonian University, Krakow, Poland; The Methodist Hospital Research Institute (G.L.K.), Houston, Tex; Volcano Europe (A.R.), Zaventem, Belgium.

Correspondence to Dariusz Dudek, II Department of Cardiology, Institute of Cardiology, Jagiellonian University, Kopernika 17th str, 31-501 Krakow, Poland. E-mail mcdudek{at}cyf-kr.edu.pl

Objective— Safety and feasibility evaluation of intracoronary temperature measurements in patients with acute coronary syndromes (ACS) using a catheter based thermography system.

Methods and Results— Thermography was performed in 40 patients with ACS. A 3.5-F thermography catheter containing 5 thermocouples measuring vessel wall temperature, and 1 thermocouple measuring blood temperature (accuracy 0.05°C) was used. Gradient (Tmax) between blood temperature (T_bl) and the maximum wall temperature during pullback was measured. The device showed satisfactory safety in ACS. Only in 16 patients (40%) Tmax was 0.1°C. In 23 patients (57.5%) the highest Tmax was found in the culprit segment. Tmax between culprit and adjacent non-culprit segments was observed in patients with transient blood flow interruption during thermography (0.11±0.03 versus 0.08±0.01; P=0.04), in contrast to patients with preserved flow (0.07±0.03 versus 0.06±0.02; P=0.058).

Conclusions— The novel, technically sophisticated intracoronary thermography proved its safety and feasibility. However, we were not able to convincingly and consistently differentiate between different lesions at risk, despite a selection of lesions that should appear most distinct to differentiate. A systematic interruption of flow may be necessary to achieve diagnostic results consistently, although such requirement may unfavorably change the risk-to-benefit ratio of this developing technology.

We performed an intracoronary thermography study in 40 arteries responsible for ACS. Temperature gradient between culprit and nonculprit segments was observed only when transient blood flow interruption occurred during thermography. Because of the blood cooling effect on the arterial wall the novel thermography system failed to differentiate lesions at risk.

Key Words: infarction • ischemia • plaque • temperature • thermography

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