Interventional Cardiology. Группа авторов

caliber to the human coronary artery. Twenty‐four hours after an intravenous injection of Prosense VM110, a NIRF molecular imaging agent that reports on cathepsin protease activity in atheroma, in vivo intravascular NIRF‐OCT was performed. NIRF revealed augmented protease activity in OCT‐defined atheroma, with substantial inflammation heterogeneity seen across atheroma (a,d). The OCT catheter is seen in the middle of the image; the NIRF signal intensity (representing quantitative protease inflammatory activity) is represented by a color scale bar mapped on to the luminal border. The NIRF‐OCT findings were confirmed by histology (H&E, middle column b and e), and cathepsin B immunohistochemistry (right column, c and f).

      Source: Yoo et al. 2011 [135]. Reproduced with permission of Nature Publishing Group.

      Clinical translation

       NIRF‐OCT imaging system

      Recently, investigators performed the first human coronary imaging studies of patients using a clinically approved NIRF‐OCT catheter [147]. While this catheter was used to detect plaque NIR autofluorescence, or NIRAF (no imaging agent was injected), the ability to safely acquired NIRF‐OCT images is a major step forward in realizing intracoronary molecular imaging. NIRAF itself may indicated the presence of intraplaque hemorrhage [148].

       NIRF molecular imaging agents

In addition to having a clinically approved catheter, clinical NIRF molecular imaging agents will be required. A promising candidate is indocyanine green (ICG), an amphiphilic molecule that has been FDA‐approved for decades to study cardiac, hepatic, and retinal blood flow. In 2011, Vinegoni et al. [140] showed that ICG can unexpectedly target plaque macrophages and plaque lipid in areas of heightened endothelial permeability, and thus could be useful for clinical intracoronary NIRF molecular imaging of vulnerable plaques. This finding was recently confirmed by others [149], and recently in human carotid atheroma patients [150]. Beyond ICG, many targeted NIRF agents are expected to be available for arterial disease in the future, driven primarily by the field of cancer NIRF molecular imaging [151].

       Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology

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