Abstract 1840: Morphological Distribution of Plaque is not Uniform Along Coronary Vessel Walls and Adiponectin is Closely Associated with Plaque Volume with Fibro-Fatty Lesions
Background: Adiponectin has been identified as a representative marker of metabolic syndrome. Hypoadiponectinemia is observed in patients with macroangiopathy and may also predict poor clinical outcomes. Recently, spectral analysis of intravascular ultrasound (IVUS) radiofrequency (IVUS-Virtual Histology [VH]) data demonstrated a potential to provide detailed quantitative information on plaque composition. We assessed the hypothesis that adiponectin was associated with coronary plaque volume and composition and verified the difference of morphological distribution along coronary vessel walls.
Methods and Results: Preintervention IVUS-VH using a continuous pullback (0.5 mm/s) was performed prospectively in 42 coronary vessels (17 acute coronary syndrome [ACS] lesions and 25 non-ACS lesions) with coronary stenosis ≥90% in consecutive 37 patients. The morphological distribution of plaque was evaluated starting from 1 slice at culprit lesions (Group A), dividing the vessel and evaluating a 20 mm segment including culprit lesions (Group B), up to a total length of 60 mm (Group C). Plaque burden, % dense calcium and % necrotic core were significantly greater in Group A than Group B and C. (Table⇓). Especially in Group C, log-adiponectin significantly correlated with external elastic membrane-volume (r=−0.31, P=0.047), plaque plus media (PPM)-volume (r=−0.39, P=0.010), plaque burden (r=−0.32, P=0.041), fibro-fatty volume (r=−0.44, P=0.003) and % fibro-fatty volume (r=−0.41, P=0.007). A multiple regression analysis revealed that log-adiponectin was significantly associated with PPM-volume in Group C (P=0.026) rather than PPM-area in Group A (P=0.099) and volume in Group B (P=0.048).
Conclusions: The morphological distribution of plaque is not fixed at different coronary lesions. Adiponectin may predict fibro-fatty coronary volume with positive remodeling and may help to explain missing link between plaque composition and metabolic syndrome.