Positive Vascular Remodeling in Culprit Coronary Lesion is Associated With Plaque Composition: An Intravascular Ultrasound-Virtual Histology Study.
10.4070/kcj.2012.42.11.747
- Author:
Chung Seop LEE
1
;
Young Hoon SEO
;
Dong Ju YANG
;
Ki Hong KIM
;
Hyun Woong PARK
;
Hyung Bin YUK
;
Moo Sik LEE
;
Wan Ho KIM
;
Taek Geun KWON
;
Jang Ho BAE
Author Information
1. Department of Cardiology, Konyang University College of Medicine, Daejeon, Korea. janghobae@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Atherosclerosis;
Coronary artery;
Intravascular ultrasonography
- MeSH:
Atherosclerosis;
Coronary Artery Disease;
Coronary Vessels;
Humans;
Membranes;
Multivariate Analysis;
Phenobarbital;
Ultrasonography, Interventional
- From:Korean Circulation Journal
2012;42(11):747-752
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The relationship between the positive remodeling (PR) of a coronary artery and plaque composition has been studied only in a relatively small number of study population or non-culprit lesion. We evaluated the association between coronary plaque composition and coronary artery remodeling in a relatively large number of culprit lesions. SUBJECTS AND METHODS: The study population consisted of 325 consecutive patients with coronary artery disease that underwent intravascular ultrasound-virtual histology examination in a culprit lesion. The remodeling index (RI) was calculated as the lesion external elastic membrane (EEM) area divided by the average reference EEM area. RESULTS: The lesions with PR (RI>1.05, n=97, mean RI=1.19+/-0.12) had a higher fibrous volume/lesion length (3.85+/-2.12 mm3/mm vs. 3.04+/-1.79 mm3/mm, p=0.003) and necrotic core volume/lesion length (1.26+/-0.89 mm3/mm vs. 0.90+/-0.66 mm3/mm, p=0.001) than those with negative remodeling (NR) (RI<0.95, n=132, mean RI=0.82+/-0.09). At the minimal luminal area site, the lesions with PR had a higher fibrous area (5.81+/-3.17 mm2 vs. 3.61+/-2.30 mm2, p<0.001), dense calcified area (0.73+/-0.69 mm2 vs. 0.46+/-0.43 mm2, p=0.001), and necrotic core area (1.93+/-1.33 mm2 vs. 1.06+/-0.91 mm2, p<0.001) than those with NR. RI showed significant positive correlation with fibrous volume/lesion length (r=0.173, p=0.002), necrotic core volume/lesion length (r=0.188, p=0.001), fibrous area (r=0.347, p<0.001), fibrofatty area (r=0.111, p=0.036), dense calcified area (r=0.239, p<0.001), and necrotic core area (r=0.334, p<0.001). Multivariate analysis showed that the independent factor for PR was the necrotic core volume/lesion length (beta=0.130, 95% confidence interval; 0.002-0.056, p=0.037) over the entire lesion. CONCLUSION: This study suggests that PR in a culprit lesion is associated with the necrotic core volume in the entire lesion, which is a characteristic of vulnerable plaque.
