利用超声射频数据分析在体内进行血管内超声衍生的薄帽纤维粥样瘤检测。

In vivo intravascular ultrasound-derived thin-cap fibroatheroma detection using ultrasound radiofrequency data analysis.

作者信息

Rodriguez-Granillo Gastón A, García-García Héctor M, Mc Fadden Eugène P, Valgimigli Marco, Aoki Jiro, de Feyter Pim, Serruys Patrick W

机构信息

Erasmus Medical Center, Thoraxcenter, Rotterdam, The Netherlands.

出版信息

J Am Coll Cardiol. 2005 Dec 6;46(11):2038-42. doi: 10.1016/j.jacc.2005.07.064. Epub 2005 Nov 9.

DOI:10.1016/j.jacc.2005.07.064

PMID:16325038

Abstract

OBJECTIVES

The purpose of this study was to assess the prevalence of intravascular ultrasound (IVUS)-derived thin-cap fibroatheroma (IDTCFA) and its relationship with the clinical presentation using spectral analysis of IVUS radiofrequency data (IVUS-Virtual Histology [IVUS-VH]).

BACKGROUND

Thin-cap fibroatheroma lesions are the most prevalent substrate of plaque rupture.

METHODS

In 55 patients, a non-culprit, non-obstructive (<50%) lesion was investigated with IVUS-VH. We classified IDTCFA lesions as focal, necrotic core-rich (> or =10% of the cross-sectional area) plaques being in contact with the lumen; IDTCFA definition required a percent atheroma volume (PAV) > or =40%.

RESULTS

Acute coronary syndrome (ACS) (n = 23) patients presented a significantly higher prevalence of IDTCFA than stable (n = 32) patients (3.0 [interquartile range (IQR) 0.0 to 5.0] vs. 1.0 [IQR 0.0 to 2.8], p = 0.018). No relation was found between patient's characteristics such as gender (p = 0.917), diabetes (p = 0.217), smoking (p = 0.904), hypercholesterolemia (p = 0.663), hypertension (p = 0.251), or family history of coronary heart disease (p = 0.136) and the presence of IDTCFA. A clear clustering pattern was seen along the coronaries, with 35 (35.4%), 31 (31.3%), 19 (19.2%), and 14 (14.1%) IDTCFAs in the first 10 mm, 11 to 20 mm, 21 to 30 mm, and > or =31 mm segments, respectively, p = 0.008. Finally, we compared the severity (mean PAV 56.9 +/- 7.4 vs. 54.8 +/- 6.0, p = 0.343) and the composition (mean percent necrotic core 19.7 +/- 4.1 vs. 18.1 +/- 3.0, p = 0.205) of IDTCFAs between stable and ACS patients, and no significant differences were found.

CONCLUSIONS

In this in vivo study, IVUS-VH identified IDTCFA as a more prevalent finding in ACS than in stable angina patients.

摘要

目的

本研究旨在使用血管内超声（IVUS）射频数据的频谱分析（IVUS-虚拟组织学[IVUS-VH]）评估血管内超声衍生的薄帽纤维粥样斑块（IDTCFA）的患病率及其与临床表现的关系。

背景

薄帽纤维粥样斑块病变是斑块破裂最常见的基质。

方法

对55例患者的非罪犯、非阻塞性（<50%）病变进行IVUS-VH检查。我们将IDTCFA病变分类为与管腔接触的局灶性、富含坏死核心（横截面面积≥10%）的斑块；IDTCFA的定义要求粥样斑块体积百分比（PAV）≥40%。

结果

急性冠状动脉综合征（ACS）（n = 23）患者的IDTCFA患病率显著高于稳定型（n = 32）患者（3.0[四分位间距（IQR）0.0至5.0]对1.0[IQR 0.0至2.8]，p = 0.018）。未发现患者特征如性别（p = 0.917）、糖尿病（p = 0.217）、吸烟（p = 0.904）、高胆固醇血症（p = 0.663）、高血压（p = 0.251）或冠心病家族史（p = 0.136）与IDTCFA的存在之间存在关联。沿冠状动脉观察到明显的聚集模式，在前10 mm、11至20 mm、21至30 mm和≥31 mm节段中分别有35个（35.4%）、31个（31.3%）、19个（19.2%）和14个（14.1%）IDTCFA，p = 0.008。最后，我们比较了稳定型和ACS患者中IDTCFA的严重程度（平均PAV 56.9±7.4对54.8±6.0，p = 0.343）和组成（平均坏死核心百分比19.7±4.1对18.1±3.0，p = 0.205），未发现显著差异。