In vivo association between positive coronary artery remodelling and coronary plaque characteristics assessed by intravascular optical coherence tomography
In vivo association between positive coronary artery remodelling and coronary plaque characteristics assessed by intravascular optical coherence tomography
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DOI：
10.1093/eurheartj/ehn286
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发表时间：
2008-07-01
影响因子：
39.3
通讯作者：
Jang, Ik-Kyung
中科院分区：
文献类型：
--
作者：
Raffel, Owen Christopher;Merchant, Faisal M.;Jang, Ik-Kyung
冠状动脉重塑阳性与不稳定冠状动脉综合征和斑块易损性的体外组织学特征如大脂质核心和高巨噬细胞含量有关。本研究的目的是评价冠状动脉重塑和光学相干断层扫描（OCT）识别的潜在斑块特征之间的体内相关性。OCT是一种独特的成像方式，能够表征这些重要的形态学特征的易损plaic.Methods和结果OCT和血管内超声成像进行相应的网站在接受导管插入术的患者。OCT斑块的脂质含量，纤维帽厚度和巨噬细胞密度的特征，使用先前验证的标准。薄帽纤维粥样硬化（TCFA）定义为纤维帽厚度< 65 μ m的富脂斑块（两个或多个象限）。重构指数（RI）计算为病变与参考外弹力膜面积的比值。共对48例患者的54处病变进行了成像。与无或阴性重构相比，阳性重构更常与富脂斑块（100 vs. 60 vs. 47.4%，P = 0.01）、薄纤维帽（中位数40.2 vs. 51.6 vs. 87 μ m，P = 0.003）和TCFA的存在（80 vs. 38.5 vs. 5.6%，P < 0.001）相关。纤维帽巨噬细胞密度与RI呈正相关（r = 0.60，P < 0.001）。结论冠状动脉斑块具有易损斑块的特征。这可能解释了积极重塑和不稳定的临床表现之间的联系。
Aims Positive coronary arterial remodelling has been shown to be associated with unstable coronary syndromes and ex vivo histological characteristics of plaque vulnerability such as a large lipid core and high macrophage content. The aim of this study is to evaluate the in vivo association between coronary artery remodelling and underlying plaque characteristics identified by optical coherence tomography (OCT). OCT is a unique imaging modality capable of characterizing these important morphological features of vulnerable plaque.Methods and results OCT and intravascular ultrasound imaging was performed at corresponding sites in patients undergoing catheterization. OCT plaque characteristics for lipid content, fibrous cap thickness, and macrophage density were derived using previously validated criteria. Thin-cap fibroatheroma (TCFA) was defined as lipid-rich plaque (two or more quadrants) with fibrous cap thickness < 65 mu m. Remodelling index (RI) was calculated as the ratio of the lesion to the reference external elastic membrane area. A total of 54 lesions from 48 patients were imaged. Positive remodelling compared with absent or negative remodelling was more commonly associated with lipid-rich plaque (100 vs. 60 vs. 47.4%, P = 0.01), a thin fibrous cap (median 40.2 vs. 51.6 vs. 87 mu m, P = 0.003) and the presence of TCFA (80 vs. 38.5 vs. 5.6%, P < 0.001). Fibrous cap macrophage density was also higher in plaques with positive remodelling showing a positive linear correlation with the RI ( r = 0.60, P < 0.001).Conclusions Coronary plaques with positive remodelling exhibit characteristic features of vulnerable plaque. This may explain the link between positive remodelling and unstable clinical presentations.