아주대학교병원 순환기내과
정명일, 최소연, 임홍석, 양형모, 박진선, 황정원, 최운정, 강수진, 최병주, 윤명호, 황교승, 신준한, 탁승제
Study aim: The aim of this study was to analyze three-vessel volumetric distribution of plaque composition according to classical cardiovascular risk factors and metabolic syndrome (MS) by using virtual histology intravascular ultrasound (VH-IVUS). Methods: Three-vessel VH-IVUS images were obtained in 56 patients. Volumetric VH-IVUS analyses of all plaques of three vessels were compared to the cardiovascular risk factors. Results: Mean of analyzed length was 54.9±17.6 mm for LAD, 50.7±19.5 mm for LCx and 72.6±19.0 mm for RCA. Whole length was not different regardless of risk factors (p>0.05). The volumetric three-vessel plaque composition had no significant relation with age, smoking, hypertension and dyslipidemia. Necrotic core (NC) volume (88.5±69.8 vs. 49.3±38.2mm3, p=0.009) and percentage (45.4±20.4 vs. 34.0±16.5, p=0.041) were higher in men. There were significantly larger plaque volume (1220.1±433.1 vs. 950.1±316.3mm3, p=0.018), dense calcium (DC) volume (57.7±63.5 vs.27.8±22.2mm3, p=0.014) and NC volume (90.0±70.4 vs.48.5±36.8mm3, p=0.005) in acute coronary syndrome (ACS) group. DC percentage (31.6±15.2 vs. 21.7±16.2, p=0.046), NC volume (118.8±79.2 vs. 59.2±48.8mm3, p=0.014) and percentage (54.1±17.3 vs. 36.9±18.8, p=0.003) were higher in diabetes mellitus (DM) patients. There were significantly larger total plaque volume (1425.5±341.7 vs. 1002.9±379.3mm3, p<0.001), DC (74.8±52.0 vs. 35.9±51.6mm3, p=0.014) and NC (131.2±82.1 vs. 52.8±35.7mm3, p=0.002) volume in MS group. NC volume and percentage, plaque volume, and DC volume significantly increased with the MS scores rising (p=0.000, 0.042, 0.015 and 0.022 respectively). Conclusions: Three-vessel VH-IVUS volumetric analysis showed more NC in male, MS and DM patients and it implies higher plaque vulnerability in these groups.
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