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ȣ - 520638 157 |
| Longitudinal Distribution of Plaque Components in Coronary Stenotic Lesion
: Virtual Histology-Intravascular Ultrasound analysis
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| 아주대학교 병원 순환기 내과 |
| 양형모, 최소연, 정명일, 박세준, 이유홍, 이윤석, 박진선, 최운정, 황정원, 임홍석, 강수진, 최병주, 윤명호, 황교승, 신준한, 탁승제 |
Background: Plaque components, especially necrotic core, are related to plaque vulnerability. Study for the longitudinal distribution of plaque components in coronary stenotic lesion is unknown. For the understanding of plaque characteristics in coronary stenotic lesion, we aimed to estimate the longitudinal distribution of plaque components in coronary stenotic lesion by Virtual Histology-Intravascular Ultrasound Study (VH-IVUS). Methods: Sixty five de novo coronary stenotic lesions (LAD, 44; LCX, 12; RCA, 9) in 64 patients (49 acute coronary syndrome) were evaluated by VH-IVUS. The atherosclerotic lesion with plaque burden ≥50% were analysed and evenly divided into 5 segments from proximal to distal (segment 1-5), longitudinally. Cross sectional measurement of four different plaque components (fibrous, fibrofatty, necrotic core, dense calcium) and tissue maps for coronary plaque characterization were done using VH-IVUS software. The average value of the area and the percentage for plaque components were obtained at each segments. Results: The mean reference vessel diameter was 3.27 ± 0.36 mm and mean minimal lumen area was 3.67 ± 0.78 mm2. The mean length of lesion with plaque burden ≥50% by VH-IVUS was 19.4 ± 9.5 mm. The area of necrotic core (β= 0.073, p= 0.023) and dense calcium (β= 0.046, p = 0.024) were increased, the area of fibrofatty (β= -0.081, p = 0.005) was decreased from segment 5 to segment 1. The percentage of necrotic core (β= 1.074, p= 0.012) and dense calcium (β= 0.823, p = 0.010) were increased, the percentage of fibrofatty (β= -0.960, p = 0.020) was decreased from segment 5 to segment 1. Total 18 thin cap fibroatheroma (TCFA) were detected in the lesion and most common at segment 1 (38.8%). Conclusion: The necrotic core and dense calcium were increased with the proximal portion of coronary stenotic lesion and TCFA was common at proximal site of lesion. For the prevention of future rupture, the full coverage of proximal portion of coronary stenotic lesion during percutaneous coronary intervention is important.
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