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The dynamic nature of coronary artery lesion morphology assessed by serial virtual histology intravascular ultrasound tissue characterization.

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dc.contributor.authorKubo, T-
dc.contributor.authorMaehara, A-
dc.contributor.authorMintz, GS-
dc.contributor.authorDoi, H-
dc.contributor.authorTsujita, K-
dc.contributor.authorChoi, SY-
dc.contributor.authorKatoh, O-
dc.contributor.authorNasu, K-
dc.contributor.authorKoenig, A-
dc.contributor.authorPieper, M-
dc.contributor.authorRogers, JH-
dc.contributor.authorWijns, W-
dc.contributor.authorBose, D-
dc.contributor.authorMargolis, MP-
dc.contributor.authorMoses, JW-
dc.contributor.authorStone, GW-
dc.contributor.authorLeon, MB-
dc.description.abstractOBJECTIVES: We used virtual histology intravascular ultrasound (VH-IVUS) to investigate the natural history of coronary artery lesion morphology.

BACKGROUND: Plaque stability is related to its histological composition.

METHODS: We performed serial (baseline and 12-month follow-up) VH-IVUS studies and examined 216 nonculprit lesions (plaque burden >or=40%) in 99 patients. Lesions were classified into pathological intimal thickening (PIT), VH-IVUS-derived thin-capped fibroatheroma (VH-TCFA), thick-capped fibroatheroma (ThCFA), fibrotic plaque, and fibrocalcific plaque.

RESULTS: At baseline, 20 lesions were VH-TCFAs; during follow-up, 15 (75%) VH-TCFAs "healed," 13 became ThCFAs, 2 became fibrotic plaque, and 5 (25%) VH-TCFAs remained unchanged. Compared with VH-TCFAs that healed, VH-TCFAs that remained VH-TCFAs located more proximally (values are median [interquartile range]) (16 mm [15 to 18 mm] vs. 31 mm [22 to 47 mm], p = 0.013) and had larger lumen (9.1 mm(2) [8.2 to 10.7 mm(2)] vs. 6.9 mm(2) [6.0 to 8.2 mm(2)], p = 0.021), vessel (18.7 mm(2) [17.3 to 28.6 mm(2)] vs. 15.5 mm(2) [13.3 to 16.6 mm(2)]; p = 0.010), and plaque (9.7 mm(2) [9.6 to 15.7 mm(2)] vs. 8.4 mm(2) [7 to 9.7 mm(2)], p = 0.027) areas; however, baseline VH-IVUS plaque composition did not differ between VH-TCFAs that healed and VH-TCFAs that remained VH-TCFAs. Conversely, 12 new VH-TCFAs developed; 6 late-developing VH-TCFAs were PITs, and 6 were ThCFAs at baseline. In addition, plaque area at minimum lumen sites increased significantly in PITs (7.8 mm(2) [6.2 to 10.0 mm(2)] to 9.0 mm(2) [6.5 to 12.0 mm(2)], p < 0.001), VH-TCFAs (8.6 mm(2) [7.3 to 9.9 mm(2)] to 9.5 mm(2) [7.8 to 10.8 mm(2)], p = 0.024), and ThCFAs (8.6 mm(2) [6.8 to 10.2 mm(2)] to 8.8 mm(2) [7.1 to 11.4 mm(2)], p < 0.001) with a corresponding decrease lumen areas, but not in fibrous or fibrocalcific plaque.

CONCLUSIONS: Most VH-TCFAs healed during 12-month follow-up, whereas new VH-TCFAs also developed. PITs, VH-TCFAs, and ThCFAs showed significant plaque progression compared with fibrous and fibrocalcific plaque.
dc.subject.MESHCoronary Artery Disease/*diagnosis-
dc.subject.MESHCoronary Vessels/*pathology/ultrasonography-
dc.subject.MESHDiagnosis, Differential-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHHistological Techniques/*methods-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProspective Studies-
dc.subject.MESHReproducibility of Results-
dc.subject.MESHTime Factors-
dc.subject.MESHUltrasonography, Interventional/*methods-
dc.subject.MESH*User-Computer Interface-
dc.titleThe dynamic nature of coronary artery lesion morphology assessed by serial virtual histology intravascular ultrasound tissue characterization.-
dc.contributor.affiliatedAuthor최, 소연-
dc.type.localJournal Papers-
dc.citation.titleJournal of the American College of Cardiology-
dc.identifier.bibliographicCitationJournal of the American College of Cardiology, 55(15):1590-1597, 2010-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
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