Vulnerable plaque in the coronaries

Prof. Dr. Helmut Kücherer was born in 1959 and was raised in Heidelberg, Germany. After completing medical school at the University of Heidelberg and internships at the Universityof California San Francisco and University hospital at Basel, Switzerland, he was appointed at the Department of Internal Medicine, University of Heidelberg were he followedhis clinical and research training in internal medicine and cardiology under the supervision of Prof. Kübler. As a scholar of the “Studienstiftung des Deutschen Volkes” and the “German Research Foundation” he completed research training at the Cardiovascular Research Institute at the University of San Francisco, Medical School (UCSF) working together with Prof. William Parmley and Prof. Nelson Schiller in the field of diastolic function. Back at the University of Heidelberg he pursued his clinical and research carrier as a board certified internist in 1994 and cardiologist in 1998. Since 2002 he is Professor of Medicine and Cardiology and was associated chief of Cardiology until 1/2007 working together with Prof.H.A. Katus. Since 2/2007 he is Chief of Cardiology at the“Kliniken im Naturpark Altmühltal” a center of community hospitals in Bavaria. His special research and clinical interests are acute coronary syndrome, myocardial perfusion and ultrasound imaging of heart and vessels.

Abstract

Coronary angiography is considered clinical gold standard in evaluating coronary artery disease and forms the basis for interventional procedures. However, neither vessel wall nor the extent of atherosclerotic changes can be judged from coronary angiography that is highlighting the luminal structure only. Intravascular ultrasound enables visualization of vessel cross sectionand coronary plaque. Plaque load and vessel dimensions can be derived from conventiona lintravascular ultrasound imaging. Specifically vascular negative or positive remodeling can beinvestigated in serial measurements adding substantially to clinical course of coronary lesions before and after coronary interventions. Until recently, it has not been possible to assess plaque composition. Plaque composition isknown to contribute to clinical status. Using IVUS plaque components can be visualized and quantified in vivo. This technology uses ultrasound backscatter signals to derive informationon plaque composition. Specific characteristics of vulnerable plaques such as thin cap fibrous atheroma can be identified using virtual histology. This entity has been frequently observed inacute coronary syndromes, specifically in the proximal third of the inflicted vessel. Intraplaque compositional changes can be analyzed along with changes in total plaque volume. This could be helpful to better understand therapeutic effects of drugs on atherosclerosis progression.