Abstract 13665: Arterial Remodeling and Coronary Plaque Compositions: An in vivo Tissue Characterization Using Integrated Backscatter-Intravascular Ultrasound
Background: Arterial remodeling is a one of the plaque characteristics of the vulnerable or unstable plaque.
Objective: The purpose of this study was to investigate the relationship between plaque composition and arterial remodeling by using integrated backscatter (IB)-intravascular ultrasound (IVUS).
Methods: A total of 77 lesions (plaque burden > 40%) from 54 patients with coronary artery disease were enrolled and studied. Remodeling index (RI) was calculated as the external elastic membrane (EEM) area at the minimal lumen area (MLA) site divided by average EEM area at the proximal and distal reference sites. Lesions were grouped according to the presence (PR group; RI > 1) or absence (non-PR group; RI ≤ 1) of PR. Plaque characteristics were categorized as either calcification, dense fibrosis, fibrous or lipid by using IB-IVUS. We compare plaque composition and prevalence of thin-cap fibroatheroma (TCFA) between PR group and non-PR group. An IB-IVUS-derived TCFA was defined as a lesion with confluent lipid plaque (≥ 55%) being directly in contact with coronary lumen.
Results: Percent lipid area in the PR group (n=38) was significantly greater than the non-PR group (n = 39) (54.7 ± 15.8 % vs. 40.8 ± 14.2 %, p<0.001). In contrast, % fibrous area in the PR group was significantly lower than the non-PR group (39.8 ± 12.2 % vs. 48.6 ± 9.5 %, p < 0.001). TCFA was more frequently found in PR group than in non-PR group (58 % vs. 18 %, p < 0.001).
Conclusions: Lesions with PR had more lipid plaque and less fibrous plaque. High prevalence of TCFA in PR may account for the plaque vulnerability of the positively remodeled coronary arterial lesions.
- Cardiovascular imaging
- Intravascular ultrasound/Doppler
- Coronary artery disease
- Interventional cardiology
- Coronary vessels
- © 2010 by American Heart Association, Inc.