Morphological characteristics of ostial and non-ostial left main corollary artery lesion without heavy calcification determined by intravascular ultrasound imaging
10.3321/j.issn:0253-3758.2008.11.005
- VernacularTitle:左主干冠状动脉病变的血管内超声研究
- Author:
Xue-Bo LIU
1
;
Ju-Ying QIAN
;
Lei GE
;
Feng ZHANG
;
Bing FAN
;
Qi-Bing WANG
;
Yan LU
;
Jun-Bo GE
Author Information
1. 复旦大学附属中山医院
- Keywords:
Coronary disease;
Ultrasonography,interventional
- From:
Chinese Journal of Cardiology
2008;36(11):975-979
- CountryChina
- Language:Chinese
-
Abstract:
Objective We aimed to assess and compare the morphological characteristics of ostial and non-ostial left main coronary artery (LMCA) lesion without heavy calcification using intravascular ultrasound (IVUS) imaging.Methods Between Oct.2004 and Oct.2007,153 patients with confirmed or suspected coronary artery narrowing in coronary angiography with satisfactory IVUS images and non-heavy calcifieation were inchded in the study (ostial lesions,n=47;non-ostial lesion,n=106).IVUS analysis included plaque composition,external elastic membrane (EEM),lumen,plaque cross-sectional area (CSA),plaque burden (plaque CSA/EEM CSA) at the lesion,proximal and/or distal reference site,and remodeling index (RI,lesion EEM CSA/reference EEM CSA).Negative remodeling was defined as RI＜0.95.Results LMCA mean reference lumen and vessel diameter was 4.1.±0.8 mm and 5.3.±0.8 mm respectively.Incidence of patients with minimum lumen area (MLA＜6.0 mm2) was similar between the two groups (29.5% for ostial Iesions and 31.9% for non-ostial Iesions,P=0.87).There were significantly more fibrous (70.2% vs.35.8%) and soft (8.5%vs.3.8%) plaques while significantly less calcified plaque (1 9.2% vs.43.4%) in patients with ostile lesions compared those with non-ostial lesions (all P＜0.05).Compared to non-ostial lesions,ostial lesion had significant smaller plaque area [(10.8.±4.5)mm2 vs.(13.3±5.4) mm2,P=0.007],less plaque burden (54.8%.±15.9% vs.61.9%.±14.5%,P=0.020),smaller RI (0.9±0.2 vs.1.0±0.2,P=0.000) and higher incidence of negative remodeling (74.5% vs.34.9%,P=0.000).Multivariant Logistic regression analysis showed that the site of lesion (ostial or non-estial lesion,Or=4.9,P=0.004),plaque area (OR=1.2,P=0.01) and plaque burden (OR=0.003,P=0.000) were the independent predictors of LMCA remodeling.Conclusion Negative remodcling might be responsible for the development of LMCA ostial narrowing.
