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Techniques Can Locate Culprit Plaque in Heart Attack

Ultrasound, thermography more useful than angiography

TUESDAY, Nov. 27 (HealthDay News) -- Ultrasound and thermography can be more useful than angiography in locating the culprit plaque in patients with acute myocardial infarction, particularly those with total occlusion of the coronary artery, according to study findings published in the Dec. 4 issue of the Journal of the American College of Cardiology.

Takuro Takumi, M.D., from Kagoshima City Hospital in Japan, and colleagues examined whether the maximal temperature site (measured by thermal wire) coincided with the culprit plaque (measured by intravascular ultrasound) in the left anterior descending coronary artery of 45 consecutive patients with a first anterior acute myocardial infarction.

The researchers found that 25 patients had total occlusion of the coronary artery while the remaining 20 patients had reperfusion. The maximal temperature site was more distal to the most stenotic or occlusive site by angiography. In patients with reperfusion, the culprit plaques determined by ultrasound, angiography and thermography were in relatively close proximity. In contrast, in patients with occlusion, the angiographic occlusive site was more proximal to the culprit plaque as determined by ultrasound and thermography.

"The fact that there was a good correlation between the maximal temperature site and that of intravascular ultrasound adds additional validation to the use of thermography for the detection of culprit plaques in vivo and suggests that modalities aimed at detecting temperature as a surrogate for inflammation might be useful for localizing the culprit plaque," Aloke V. Finn, M.D., from Emory University School of Medicine in Atlanta, and colleagues write in an accompanying editorial.

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