In vivovisualization of lipid coronary atheroma with intravascular near-infrared spectroscopy

INTRODUCTION: Atherosclerotic cardiovascular disease (ASCVD) has become a major health burden and is expected to further increase in the future. Better predictive approaches for ASCVD and more efficacious therapies are required to further improve cardiovascular outcomes. Intravascular imaging has contributed to the elucidation of atherosclerotic mechanisms and evaluation of novel therapies. Near-infrared spectroscopy has enabled the visualization of the lipid extent of atherosclerotic plaques in vivo. Given that lipid accumulation is considered to promote the formation and progression of atherosclerosis, this technology may harbor the potential to identify subjects with high cardiovascular risks and thus adopt more optimized therapeutic approaches. Areas covered: This review will outline the characteristics of NIRS, its validation data and in vivo findings of NIRS imaging in patients with coronary artery disease. The comparisons of NIRS with other imaging modalities will reveal the distinct capability of NIRS imaging to monitor high-risk atheroma harboring lipidic composition. Furthermore, the predictive ability of NIRS-derived measures in the occurrence of ASCVD will be summarized. Expert commentary: Ex vivo and in vivo findings suggest NIRS imaging as a potential tool for cardiovascular risk assessment and monitoring the benefit of pharmacological approaches.