Spatial Distribution of Vulnerable Plaques Comprehensive In Vivo Coronary Plaque Mapping
Spatial Distribution of Vulnerable Plaques Comprehensive In Vivo Coronary Plaque Mapping
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DOI：
10.1016/j.jcmg.2020.01.013
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发表时间：
2020-09-01
影响因子：
14
通讯作者：
Jang, Ik-Kyung
中科院分区：
文献类型：
--
作者：
Araki, Makoto;Soeda, Tsunenari;Jang, Ik-Kyung
作者对我们的3支血管光学相干断层扫描（OCT）database.Background中不同表型的冠状动脉斑块的分布进行了全面分析，以往的病理学研究表明，薄帽纤维粥样硬化（TCFA）局限于心外膜冠状动脉的特定节段。各种表型的体内冠状动脉斑块的详细描述尚未reported.METHODS OCT图像的所有3个冠状动脉在131例患者进行了分析，每1毫米，以评估斑块的表型和功能的脆弱性。结果在393支冠状动脉中发现的534个斑块中，纤维斑块占27.0%，纤维钙化斑块占13.3%，厚帽纤维粥样斑块占40.8%，TCFA占18.9%。TCFA在近段呈聚集性，尤其是在左前降支。另一方面，纤维斑块相对均匀地分布在冠状动脉的整个长度。急性冠状动脉综合征（ACS）患者的TCFA在左前降支近端聚集性较强，右冠状动脉有2个簇状峰，回旋支有1个簇状峰。非ACS患者TCFA分布模式不明显。TCFA的患病率在最高的%AS三分位数中高于最低的% A5三分位数（30%vs.9%，p < 0.001）。结论目前的3支血管OCT研究显示TCFA聚集在心外膜冠状动脉的特定位置，尤其是在ACS患者中。TCFA在狭窄段中更常见。(C)2020年由美国心脏病学会基金会。
OBJECTIVES The authors performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database.BACKGROUND Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardiat coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported.METHODS OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS).RESULTS Among 534 plaques identified in 393 coronary arteries, 27.0% were fibrous plaques, 13.3% were fibrocalcific plaques, 40.8% were thick-cap fibroatheromas, and 18.9% were TCFAs. TCFAs showed clustering in the proximal segment, particularly in the left anterior descending artery. On the other hand, fibrous plaques were relatively evenly distributed throughout the entire length of the coronary arteries. In patients with acute coronary syndromes (ACS), TCFAs showed stronger proximal clustering in the left anterior descending, 2 dustering peaks in the right coronary artery, and 1 clustering peak in the circumflex artery. The pattern of TCFA distribution was less obvious in patients without ACS. The prevalence of TCFA was higher in the highest %AS tertile, compared with the lowest %A5 tertite (30% vs. 9%; p < 0.001).CONCLUSIONS The present 3 vessel OCT study showed that TCFAs duster at specific locations in the epicardiat coronary arteries, especially in patients with ACS. TCFA was more prevalent in segments with tight stenosis. (C) 2020 by the American College of Cardiology Foundation.