Conformational change in coronary artery structure assessed by optical coherence tomography in patients with vasospastic angina.
Conformational change in coronary artery structure assessed by optical coherence tomography in patients with vasospastic angina.
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DOI：
10.1016/j.jacc.2011.06.046
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发表时间：
2011-10-04
影响因子：
24
通讯作者：
Akasaka T
中科院分区：
文献类型：
--
作者：
Tanaka A;Shimada K;Tearney GJ;Kitabata H;Taguchi H;Fukuda S;Kashiwagi M;Kubo T;Takarada S;Hirata K;Mizukoshi M;Yoshikawa J;Bouma BE;Akasaka T
本研究的目的是利用光学相干断层扫描技术研究血管痉挛性病变中动脉结构的构象变化。冠状动脉痉挛在缺血性心脏病的发病机制中起重要作用。血管痉挛时各动脉层的构象变化尚未详细研究。在冠状动脉痉挛激发试验中，我们用光学相干断层扫描评估了19支冠状动脉（10支痉挛病变和9支非痉挛病变）。内膜隆起定义为1个或多个内膜突起进入管腔，在硝酸甘油（NTG）给药后消失。内膜聚集定义为内膜折叠/聚集，导致管腔轮廓出现多处扭结，NTG给药后消退。与非痉挛病变相比，痉挛病变更频繁地显示基线时的内膜隆起和痉挛期间的内膜聚集（分别为痉挛80% vs.非痉挛0%，p < 0.01，痉挛100% vs.非痉挛0%，p < 0.01）。基线时痉挛病变显示最大中膜厚度较厚（痉挛0.24 ± 0.04 mm vs.非痉挛0.12 ± 0.03 mm，p < 0.01），而NTG给药后未观察到差异（痉挛0.13 ± 0.03 mm vs.非痉挛0.13 ± 0.02 mm，p = 0.65）。我们的研究结果表明，即使在无症状的状态下，血管痉挛性心绞痛患者的中膜收缩也会发生，并促进内膜隆起的形成。痉挛时管腔狭窄与内膜聚集有关，但内膜面积无变化。
The aim of this study was to investigate the conformational change of arterial structure in the vasospastic lesion with optical coherence tomography. Coronary artery spasm plays an important role in the pathogenesis of ischemic heart diseases. The conformational change of each arterial layer during vasospasm has not been studied in detail. We assessed 19 coronary arteries (10 spasm and 9 nonspasm lesions) with optical coherence tomography during the provocation test for coronary spasm. An intimal bump was defined as 1 or more intimal projections into the lumen that disappeared after the administration of nitroglycerine (NTG). Intimal gathering was defined as a folding/gathering of the intima, resulting in multiple kinks in the luminal contour that resolved after the administration of NTG. The spasm lesion more frequently showed an intimal bump at baseline and intimal gathering during spasm compared with the nonspasm lesion (spasm 80% vs. nonspasm 0%, p < 0.01, spasm 100% vs. nonspasm 0%, p < 0.01, respectively). The spasm lesion demonstrated a thicker maximum media thickness (spasm 0.24 ± 0.04 mm vs. nonspasm 0.12 ± 0.03 mm, p < 0.01) at baseline, whereas no differences were observed after the administration of NTG (spasm 0.13 ± 0.03 mm vs. nonspasm 0.13 ± 0.02 mm, p = 0.65). Our results suggest that medial contraction occurs even in an asymptomatic state and facilitates the formation of an intimal bump in patients with vasospastic angina. Luminal narrowing during spasm is associated with intimal gathering without alteration of intimal area.
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影响因子：
37.8
作者：
Kugiyama, K;Yasue, H;Kawano, H
通讯作者：
Kawano, H
影响因子：
37.8
作者：
Tanaka, Atsushi;Imanishi, Toshio;Akasaka, Takashi
通讯作者：
Akasaka, Takashi
影响因子：
37.8
作者：
Yabushita, H;Bourna, BE;Tearney, GJ
通讯作者：
Tearney, GJ
影响因子：
3.3
作者：
Kume, T;Akasaka, T;Yoshida, K
通讯作者：
Yoshida, K
影响因子：
3.5
作者：
Hong, Young Joon;Jeong, Myung Ho;Kang, Jung Chaee
通讯作者：
Kang, Jung Chaee