Mechanical and structural characteristics of vulnerable plaques: Analysis by coronary angioscopy and intravascular ultrasound
Mechanical and structural characteristics of vulnerable plaques: Analysis by coronary angioscopy and intravascular ultrasound
复制标题
DOI：
10.1016/s0735-1097(01)01315-8
复制
发表时间：
2001-07-01
影响因子：
24
通讯作者：
Sakai, S
中科院分区：
文献类型：
--
作者：
Takano, M;Mizuno, K;Sakai, S
目的使用冠状动脉血管镜检查和血管内超声评估易损斑块的机械和结构特征。背景斑块的机械应力和成分在斑块破坏中发挥重要作用。方法对38名患者的38个病变进行干预前检查。使用冠状动脉血管镜检查将斑块分为黄色或白色。血管内超声成像与心电图和冠状动脉内压记录同时进行，以计算扩张指数和刚度β。此外，还对重塑类型进行了分类。 结果 我们确定了 27 名黄色斑块患者和 11 名白色斑块患者。黄色斑块患者出现急性冠脉综合征的频率高于稳定性心绞痛（85% vs. 36%，p < 0.01）。黄色斑块的膨胀指数显着大于白色斑块（2.7 +/- 0.8 mm Hg-1 vs. 0.7 +/- 0.8 mm Hg-1，p < 0.0001），而白色斑块的刚度β显着大于黄色斑块（34.9 +/- 16.3 vs. 8.7 +/- 2.7，p < 0.0001）。黄色斑块比白色斑块更频繁地出现代偿性扩大（56% vs. 9%，p < 0.01），而白色斑块比黄色斑块更频繁地出现反常收缩（64% vs. 4%，p < 0.001）。 结论 具有增加的扩张性和代偿性扩大的黄色斑块可能在机械和结构上较弱。因此，重复拉伸引起的机械“疲劳”可能会导致斑块破裂。具有高扩张性和代偿性扩大的斑块可能很脆弱。 (J Am Cell Cardiol 2001；38:99-104) (C) 2001 年，美国心脏病学会。
OBJECTIVES Mechanical and structural characteristics of vulnerable plaques were evaluated using coronary angioscopy and intravascular ultrasound.BACKGROUND Mechanical stress and composition of plaques pig an important role in plaque disruption.METHODS Thirty-eight lesions in 38 patients were examined pre-interventionally. The plaques were classified as either yellow or white using coronary angioscopy. Intravascular ultrasound imaging was performed simultaneously with electrocardiographic and intracoronary pressure recordings to calculate distensibility index and stiffness beta. Moreover, the type of remodeling was classified.RESULTS We identified 27 patients with yellow plaques and 11 patients with white plaques. Patients with yellow plaques presented acute coronary syndromes more frequently than stable angina (85% vs. 36%, p < 0.01). The distensibility index in yellow plaques was significantly greater than it was in white plaques (2.7 +/- 0.8 mm Hg-1 vs. 0.7 +/- 0.8 mm Hg-1, p < 0.0001), while stiffness beta for white plaques was significantly greater than it was for yellow plaques (34.9 +/- 16.3 vs. 8.7 +/- 2.7, p < 0.0001). Compensatory enlargement occurred more frequently with yellow plaques than with white plaques (56% vs. 9%, p < 0.01), while paradoxical shrinkage occurred more frequently with white plaques than it did with yellow plaques (64% vs. 4%, p < 0.001).CONCLUSIONS Yellow plaques with an increased distensibility and a compensatory enlargement may be mechanically and structurally weak. As a result, mechanical "fatigue," caused by repetitive stretching, may lead to plaque disruption. Plaques with a high distensibility and a compensatory enlargement may be vulnerable. (J Am Cell Cardiol 2001;38:99-104) (C) 2001 by the American College of Cardiology.