Impact of renal function on coronary plaque composition

肾功能对冠状动脉斑块组成的影响

• 批准号: 20790522
• 负责人: ISHII Hideki
• 金额: $ 2.66万
• 依托单位: Nagoya University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Young Scientists (B)
• 财政年份: 2008
• 资助国家: 日本
• 起止时间: 2008 至 2009
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-20790522/
• 关键词: 循環器; 慢性腎疾患; 冠動脈; 動脈硬化; 血管内超音波

Background : Recent studies have demonstrated that patients with chronic kidney disease are at high risk of atherosclerosis. Recently, coronary plaque components can be evaluated by integrated-backscatter intravascular ultrasound (IB-IVUS) and lipid-rich plaque is associated with vulnerable plaque. This aim of the study was to investigate relationship between renal function and tissue characterization of coronary plaque composition at the target stenotic site for percutaneous coronary intervention (PCI).Methods : We prospectively performed IB-IVUS before elective PCI to 89 consecutive patients with stable angina. According to estimated glomerular filtration rate (eGFR), they were divided into the two groups (eGFR<60 ml/min/1.73m2 or eGFR≧60 ml/min/1.73m2). The tissue characteristics of the coronary plaque at each target stenotic site were evaluated by three-dimensional IB-IVUS just before PCI procedure.Results : Patients with eGFR<60 ml/min/1.73m2 had higher percentage of lipid volume and lower percentage of fibrous volume compared to patients with eGFR≧60 ml/min/1.73m2 on the 3-D IB-IVUS images (36.7±10.6% vs.28.7±9.3%, P<0.001 and 59.1±8.7% vs. 66.3±8.3%, P<0.001, respectively). eGFR showed a significant negative correlation with lipid volume and had a significant positive correlation with fibrous volume in coronary plaques(r=-0.44, p<0.0001, and r=0.46, p<0.0001, respectively)Conclusions : Impaired renal function was related to higher percentage of lipid volume and lower percentage of fibrous volume in coronary plaque. Our findings may explain the increasing risk of cardiovascular events in patients with renal dysfunction.

背景：最近的研究表明，慢性肾脏病患者是动脉粥样硬化的高危人群。近年来，积分背向散射血管内超声（IB-IVUS）可用于评价冠状动脉斑块成分，且富含脂质的斑块与易损斑块相关。本研究的目的是探讨肾功能与经皮冠状动脉介入治疗（PCI）目标狭窄部位冠状动脉斑块成分组织特征之间的关系。方法：我们在选择性PCI之前前瞻性地对89例稳定型心绞痛患者进行了IB-IVUS。根据估计肾小球滤过率（eGFR）分为eGFR<60 ml/min/1.73m2和eGFR ≥ 60 ml/min/1.73m2两组。在PCI手术前通过三维IB-IVUS评估每个靶狭窄部位的冠状动脉斑块的组织特征。在三维IB-IVUS图像上，eGFR<60 ml/min/1.73 m2的患者与eGFR> 60 ml/min/1.73 m2的患者相比，脂质体积百分比较高，纤维体积百分比较低（36.7±10.6% vs.28.7± 9.3%，P<0.001; 59.1±8.7% vs.66.3 ± 8.3%，P<0.001）。eGFR与脂质体积呈显著负相关，与斑块内纤维体积呈显著正相关（分别为r=-0.44，p <0.0001和r=0.46，p<0.0001）。结论：肾功能损害与斑块内脂质体积百分比升高和纤维体积百分比降低有关。我们的研究结果可以解释肾功能不全患者心血管事件风险增加的原因。

项目成果

Plaque Burden at Left Main Coronary Artery of Patients Undergoing Percutaneous Coronary Intervention with Metabolic Syndrome.

代谢综合征患者接受经皮冠状动脉介入治疗时左主冠状动脉的斑块负担。

• 发表时间: 2008
• 作者: Miyagi M;Ishii H;Murakami R;Isobe S;Hayashi M;Amano T;Kosuke A;Ohashi T;Uetani T;Matsubara T;Murohara T.
• 通讯作者: Murohara T.

Impact of chronic statin therapy on coronary plaque composition at angiographically severe lesions : a non-randomized study focused on history of chronic statin treatment before coronary angioplasty

慢性他汀类药物治疗对血管造影严重病变处冠状动脉斑块成分的影响：一项非随机研究，重点关注冠状动脉血管成形术前慢性他汀类药物治疗史

• 发表时间: 2009
• 期刊: Clinical Therapeutics 31
• 作者: Miyagi M;Ishii H;Murakami R;Isobe S;Hayashi M;Amano T;Kosuke A;Ohashi T;Uetani T;Matsubara T. Murohara T.
• 通讯作者: Matsubara T. Murohara T.

Plaque Burden at Left Main Coronary Artery of Patients Undergoing Percutaneous Coronary Intervention with Metabolic Syndrome

代谢综合征经皮冠状动脉介入治疗患者左主冠状动脉斑块负担

• 发表时间: 2008
• 作者: Miyagi M;Ishii H;Murakami R;Isobe S;Hayashi M;Amano T;Kosuke A;Ohashi T;Uetani T;Matsubara T;Murohara T.
• 通讯作者: Murohara T.

Impact of chronic statin therapy on coronary plaque composition at angiographically severe lesions: a non-randomized study focused on history of chronic statin treatment before coronary angioplasty.

慢性他汀类药物治疗对血管造影严重病变处冠状动脉斑块成分的影响：一项非随机研究，重点关注冠状动脉血管成形术前慢性他汀类药物治疗史。

• 发表时间: 2009
• 期刊: Clin Ther. 31
• 作者: Miyagi M;Ishii H;Murakami R;Isobe S;Hayashi M;Amano T;Kosuke A;Ohashi T;Uetani T;Matsubara T;Murohara T.
• 通讯作者: Murohara T.