Sawada Takahiro, Shite Junya, Shinke Toshiro, Watanabe Satoshi, Otake Hiromasa, Matsumoto Daisuke, Tanino Yusuke, Ogasawara Daisuke, Paredes Oscal Luis, Yokoyama Mitsuhiro
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine.
J Cardiol. 2006 Sep;48(3):141-50.
Elevated circulating C-reactive protein (CRP)is commonly observed in patients with acute coronary syndrome(ACS), suggesting enhanced inflammation in vulnerable plaques. However, few data are available on the relationship between the levels of CRP and the histological composition of coronary plaque. We investigated the relationship between plasma high sensitive CRP level and coronary plaque component with Virtual Histology intravascular ultrasound (VH-IVUS).
Twenty eight patients with ACS and 37 patients with non-ACS were enrolled in the study. Plasma high sensitve CRP levels were measured before catheterization. A total of 125 lesions (ACS; 24 culprit lesions, 30 non-culprit lesions, non-ACS; 34 culprit lesions, 37 non-culprit lesions)underwent IVUS volumetric investigation, and the volume of plaque and media were calculated. Spectral analysis of IVUS radiofrequency data was performed with VH software, and plaque and media were classified into fibrous, fibro-fatty, dense calcium, and necrotic core elements.
Although the plasma high sensitive CRP level in patients with ACS was higher than that in those with non-ACS (0.26 +/- 0.2 vs 0.15 +/- 0.17 mg/dl, p < 0.05), necrotic core volume was not different between the two groups(11.7 +/- 7.3 vs 12.3 +/- 7.2mm3/cm, p = 0.71). There was a positive correlation between high sensitve CRP and necrotic core volume in patients with ACS, not only in culprit lesions (p = 0.0004, r2 = 0.564) but also in non-culprit lesions (p = 0.0008, r2 = 0.473), whereas patients with non-ACS showed no correlations.
IVUS spectral analysis revealed that elevated plasma high sensitve CRP level was correlated with necrotic core volume in patients with ACS, both in culprit and non-culprit lesions, suggesting enhanced vascular inflammation.
急性冠状动脉综合征（ACS）患者中常观察到循环C反应蛋白（CRP）升高，提示易损斑块炎症增强。然而，关于CRP水平与冠状动脉斑块组织学组成之间关系的数据很少。我们采用虚拟组织学血管内超声（VH-IVUS）研究血浆高敏CRP水平与冠状动脉斑块成分之间的关系。
本研究纳入了28例ACS患者和37例非ACS患者。在导管插入术前测量血浆高敏CRP水平。对总共125个病变（ACS；24个罪犯病变，30个非罪犯病变，非ACS；34个罪犯病变，37个非罪犯病变）进行IVUS容积研究，并计算斑块和中膜的体积。使用VH软件对IVUS射频数据进行频谱分析，将斑块和中膜分为纤维、纤维脂肪、致密钙和坏死核心成分。
尽管ACS患者的血浆高敏CRP水平高于非ACS患者（0.26±0.2 vs 0.15±0.17mg/dl，p<0.05），但两组之间的坏死核心体积没有差异（11.7±7.3 vs 12.3±7.2mm3/cm，p = 0.71）。ACS患者中，高敏CRP与坏死核心体积呈正相关，不仅在罪犯病变中（p = 0.0004，r2 = 0.
