Abstract 3423: Morphological Characteristics of Culprit Lesions by Intravascular Ultrasound Are Correlated With Local Inflammatory Activation Detected by Intracoronary Thermography
IVUS provides morphological assessment of culprit lesions (CL), while coronary thermography detects local inflammatory involvement as heat generation. This study aimed to investigate the relation of morphological and functional characteristics of CL in patients (pts) with acute coronary syndromes (ACS) and chronic stable angina (CSA).
Methods: Among pts undergoing percutaneous coronary intervention, 32 with ACS and 15 with CSA, matched for age, statin and aspirin intake, reference vessel size, and diameter stenosis (%) were enrolled. Ratio of lesion to reference external elastic membrane area, indicated by IVUS, was defined as positive (pRi>1) or negative (nRi<1) remodelling index. Temperature difference (DT) between the atherosclerotic plaque and the proximal vessel wall was measured.
Results: Baseline clinical and angiographical characteristics were similar in both groups. Pts with ACS had greater Ri (1.1 ± 0.23 vs 0.96 ± 0.12, p = 0.03) and DT (0.12 ± 0.07 vs 0.08±0.06oC, p=0.05) than pts with CSA. Pts with pRi had increased DT than pts with nRi (0.13 ± 0.06 vs 0.07±0.05oC, p=0.005). Among pts with pRi, ACS group had greater DT than CSA (0.14 ± 0.07oC vs 0.08 ± 0.04oC, p=0.05) (Figure⇓). There was a good correlation between DT and Ri (p=0.02, r=0.34).
Conclusion: A correlation of remodeling index with local inflammatory activation, assessed by intracoronary thermography, is demonstrated. The correlation between structural and functional characteristics of culprit lesions provides new insights regarding the involvement of inflammation in the pathogenesis of ACS.