Segmental coronary endothelial dysfunction in patients with minimal atherosclerosis is associated with necrotic core plaques.
Segmental coronary endothelial dysfunction in patients with minimal atherosclerosis is associated with necrotic core plaques.
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DOI：
10.1136/hrt.2009.166017
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发表时间：
2009-09
期刊：
影响因子：
--
通讯作者：
Lerman A
中科院分区：
文献类型：
--
作者：
Lavi S;Bae JH;Rihal CS;Prasad A;Barsness GW;Lennon RJ;Holmes DR Jr;Lerman A
内皮功能障碍和动脉粥样硬化是全身性疾病，但通常以节段性受累和并发症为特征。一个潜在的机制，局部参与疾病过程的早期可能与斑块组成。本研究旨在验证以下假设：在轻微冠状动脉粥样硬化患者中，内皮功能异常的冠状动脉节段具有特定的斑块特征。血管内超声（IVUS）图像来自30例接受冠状动脉内皮功能评估的患者。IVUS射频数据的频谱分析用于评估斑块组成。根据血管内皮对乙酰胆碱的反应，比较冠状动脉切片的IVUS表现。与内皮反应正常的切片相比，对乙酰胆碱有反应的心外膜冠状动脉直径减小的切片的基线管腔较小（7.5（2.4）mm 2 vs 8.8（3.3）mm 2，p = 0.006），但斑块负荷较大（37.1%（9.4%）vs 31%（7%），p = 0.003）。与内皮反应正常的切片相比，内皮功能障碍的切片具有更大的坏死核心斑块：0.13（0.03-0.33）mm 2 vs 0.0（0.0-0.07），p<0.001，以及更致密的钙：0.03（IQR 0.0-0.13）mm 2 vs 0.0（0.0-0.10）mm 2，p<0.01）。校正其他指标后，只有坏死核心区与内皮功能障碍相关（p<0.001）。这项研究表明，轻微冠状动脉粥样硬化患者的局部冠状动脉内皮功能障碍与易损斑块的典型特征相关。
Endothelial dysfunction and atherosclerosis are systemic disorders, but are often characterised by segmental involvement and complications. A potential mechanism for local involvement early in the disease process may be related to plaque composition. This study was designed to test the hypothesis that in patients with minimal coronary atherosclerosis, coronary artery segments with abnormal endothelial function have specific plaque characteristics. Intravascular ultrasound (IVUS) images were obtained from 30 patients who underwent coronary endothelial function assessment. Spectral analysis of the IVUS radiofrequency data was used for assessment of plaque composition. IVUS findings of the coronary sections were compared according to the corresponding endothelial response to acetylcholine. Sections with a decrease epicardial coronary arterial diameter in response to acetylcholine had smaller baseline lumen (7.5 (2.4) mm2 vs 8.8 (3.3) mm2, p = 0.006) but larger plaque burden (37.1% (9.4%) vs 31% (7%), p = 0.003) than sections with normal endothelial response. Sections with endothelial dysfunction had larger necrotic core plaques: 0.13 (0.03–0.33) mm2 vs 0.0 (0.0–0.07), p<0.001 and more dense calcium: 0.03 (IQR 0.0–0.13) mm2 vs 0.0 (0.0–0.10) mm2, p<0.01), than those with normal endothelial response. Only necrotic core area was associated with endothelial dysfunction (p<0.001) after adjusting for other measures. This study suggests that local coronary endothelial dysfunction in patients with minimal coronary atherosclerosis is associated with plaque characteristics that are typical of vulnerable plaques.
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影响因子：
8.3
作者：
Ghiadoni, L;Taddei, S;Salvetti, A
通讯作者：
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影响因子：
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DOI：
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发表时间：
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影响因子：
24
作者：
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通讯作者：
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影响因子：
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作者：
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