Comments on: Computed Tomographic Angiography Characteristics of Atherosclerotic Plaques Subsequently Resulting in Acute Coronary Syndrome http://www.thepreparedminds.com/archives/34 In the field of observation, chance favors the prepared minds. Sat, 04 Feb 2012 14:45:45 +0000 hourly 1 http://wordpress.org/?v=3.3 By: Jacobo Kirsch, MD http://www.thepreparedminds.com/archives/34/comment-page-1#comment-129 Jacobo Kirsch, MD Tue, 04 Aug 2009 02:52:31 +0000 http://www.thepreparedminds.com/?p=34#comment-129 Very interesting data obtained by a multivariate regression analysis in a large cohort of patients. The results from this study point in the direction of the "vulnerable plaque" theory. However, further investigations are required, such as correlative studies with IVUS as well as comparison with post ACS follow up images to determine the culprit lesions. Although I find this paper to be remarkable, I still struggle with the concept of plaque characterization when the spatial resolution is in the order of 0.6 mm and with the current 64 MDCT temporal resolution, both factors more than likely creating volume averaging artifact. Intuitively, positive remodeling may be more suitable and reproducible to assess using current state-of-the-art technology than plaque attenuation coefficient. Very interesting data obtained by a multivariate regression analysis in a large cohort of patients. The results from this study point in the direction of the “vulnerable plaque” theory. However, further investigations are required, such as correlative studies with IVUS as well as comparison with post ACS follow up images to determine the culprit lesions.

Although I find this paper to be remarkable, I still struggle with the concept of plaque characterization when the spatial resolution is in the order of 0.6 mm and with the current 64 MDCT temporal resolution, both factors more than likely creating volume averaging artifact. Intuitively, positive remodeling may be more suitable and reproducible to assess using current state-of-the-art technology than plaque attenuation coefficient.

]]> By: Paul Schoenhagen, MD, FAHA http://www.thepreparedminds.com/archives/34/comment-page-1#comment-125 Paul Schoenhagen, MD, FAHA Mon, 03 Aug 2009 14:12:18 +0000 http://www.thepreparedminds.com/?p=34#comment-125 Interesting article, demonstrating predictive value of low-attenuation and expansive remodeling of plaques assessed with MDCT for clinical events. As discussed by the authors, future studies will be necessary to evaluate the role of MDCT in the assessment of plaque vulnerability. Interesting article, demonstrating predictive value of low-attenuation and expansive remodeling of plaques assessed with MDCT for clinical events. As discussed by the authors, future studies will be necessary to evaluate the role of MDCT in the assessment of plaque vulnerability.

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