Optical coherence tomography-verified morphological correlates of high-intensity coronary plaques on non-contrast T1-weighted magnetic resonance imaging in patients with stable coronary artery disease.
Optical coherence tomography-verified morphological correlates of high-intensity coronary plaques on non-contrast T1-weighted magnetic resonance imaging in patients with stable coronary artery disease.
复制标题
DOI：
10.1093/ehjci/jey035
复制
发表时间：
2019-01-01
期刊：
影响因子：
--
通讯作者：
Yasuda S
中科院分区：
文献类型：
--
作者：
Kanaya T;Noguchi T;Otsuka F;Asaumi Y;Kataoka Y;Morita Y;Miura H;Nakao K;Fujino M;Kawasaki T;Nishimura K;Inoue T;Narula J;Yasuda S
稳定型冠状动脉疾病(CAD)患者在非对比T1加权成像上有高斑块/心肌信号强度比(PMR)的冠状动脉高信号斑块(HIP)与未来的冠状动脉事件相关。为了表征髋关节的形态基质，我们进行了相关的光学相干断层扫描(OCT)研究。我们使用3 T磁共振扫描仪对105例稳定型心绞痛或无症状性心肌缺血患者行经皮冠状动脉介入治疗。介入前对靶区进行OCT检查。HIP定义为PMR ≥ 1.4.在137个病变中，34%为髋部病变，66%为非髋部病变。HIP组富脂斑块(96%比70%，P <； 0.001)、巨噬细胞聚集(65%比46%，P = 0.046)、胆固醇结晶(46%比22%，P = 0.006)和愈合斑块破裂(多层不同光密度覆盖大量脂质积聚，72%比18%，P <； 0.001)的发生率显著高于非HIP组；两组之间薄帽纤维动脉粥样硬化瘤、冠状动脉内血栓和斑块破裂的发生率无显著差异。多因素逐步Logistic回归分析显示，髋关节与颈动脉斑块破裂相关[优势比(OR)9.32；95%可信区间(95%CI)4.05~22.71；P <； 0.001]和富脂斑块(OR 4.38；95%CI 1.08~29.77；P = 0.038)。髋关节和OCT愈合的斑块破裂和大的脂核之间的显著关联为高危斑块的特征提供了新的见解，即使在临床稳定的CAD中也是如此。
Coronary high-intensity plaques (HIPs) with a high plaque-to-myocardial signal intensity ratio (PMR) on non-contrast T1-weighted imaging in patients with stable coronary artery disease (CAD) are associated with future coronary events. To characterize the morphological substrate of HIP, we performed a correlative optical coherence tomography (OCT) study. We examined 137 lesions in 105 patients with stable angina pectoris or silent myocardial ischaemia scheduled for percutaneous coronary intervention (PCI) using a 3 T magnetic resonance scanner. Pre-interventional OCT was performed for PCI target lesions. HIP was defined as PMR ≥ 1.4. Of the 137 lesions, 34% were HIP and 66% were non-HIP. The prevalence of lipid-rich plaque (96% vs. 70%, P < 0.001), macrophage accumulation (65% vs. 46%, P = 0.046), cholesterol crystals (46% vs. 22%, P = 0.006), and healed plaque rupture (multiple layers of different optical densities overlaying a large lipid accumulation, 72% vs. 18%, P < 0.001) was significantly higher in the HIP group than the non-HIP group; no significant differences were observed for the presence of thin cap fibroatheroma, intracoronary thrombus, and plaque rupture between the two groups. Multivariable stepwise logistic regression analysis showed that HIP was significantly associated with the presence of healed plaque rupture [odds ratio (OR) 9.32; 95% confidence interval (95% CI) 4.05–22.71; P < 0.001] and lipid-rich plaque (OR 4.38; 95% CI 1.08–29.77; P = 0.038). The significant association between HIP- and OCT-derived healed plaque rupture and large lipid core provides new insights into the characteristics of high-risk plaques, even in clinically stable CAD.
登录
查看更多内容
影响因子：
39.3
作者：
Hoshi, Tomoya;Sato, Akira;Aonuma, Kazutaka
通讯作者：
Aonuma, Kazutaka
影响因子：
37.8
作者：
Jansen, C. H. P.;Perera, D.;Botnar, R. M.
通讯作者：
Botnar, R. M.
影响因子：
5.7
作者：
Mann, J;Davies, MJ
通讯作者：
Davies, MJ
影响因子：
7.5
作者：
Kataoka, Yu;Puri, Rishi;Nicholls, Stephen J.
通讯作者：
Nicholls, Stephen J.
影响因子：
2.8
作者：
Kume, T;Akasaka, T;Yoshida, K
通讯作者：
Yoshida, K