Amano Tetsuya, Matsubara Tatsuaki, Uetani Tadayuki, Nanki Michio, Marui Nobuyuki, Kato Masataka, Arai Kosuke, Yokoi Kiminobu, Ando Hirohiko, Ishii Hideki, Izawa Hideo, Murohara Toyoaki
Department of Cardiology, Chubu-Rosai Hospital, Nagoya, Japan.
J Am Coll Cardiol. 2007 Mar 20;49(11):1149-56. doi: 10.1016/j.jacc.2006.12.028. Epub 2007 Mar 6.
We assessed the impact of metabolic syndrome (MetS) on the tissue characteristics of coronary plaques using integrated backscatter intravascular ultrasound (IB-IVUS).
Metabolic syndrome is associated with the increasing risk of cardiovascular disease.
We identified MetS by the definition of the National Cholesterol Education Program in Adult Treatment Panel III criterion. Non-target coronary lesions with mild to moderate stenosis were measured by conventional and IB-IVUS parameters using 40-MHz (motorized pullback 0.5 mm/s) intravascular catheter. A total of 20 IB-IVUS images were recorded at an interval of 0.5 mm for 10 mm length in each plaque. The 3-dimensional analyses were performed using commercially available software.
The prevalence of MetS was 61 patients (50%) with 73 lesions (49%) among 122 patients with 148 lesions. Patients with MetS showed a significant increase in percentage lipid area (38 +/- 19% vs. 30 +/- 19%, p = 0.02) and percentage lipid volume (39 +/- 17% vs. 33 +/- 17%, p = 0.03), and they also showed a significant decrease in percentage of fibrous volume (57 +/- 14% vs. 61 +/- 13%, p = 0.03). Multivariate regression analysis after adjustment for potentially confounding risk factors showed that MetS remains correlated independently with the percentage of lipid volume (r = 0.223, p = 0.01). Logistic regression analysis after adjusting for confounding and non-MetS coronary risk factors showed that MetS (odds ratio 4.00, 95% confidence interval 1.33 to 12.0, p = 0.01) is proved to be an independent predictor of the lipid-rich plaque.
Metabolic syndrome is associated with lipid-rich plaques, contributing to the increasing risk of plaque vulnerability.
我们使用背向散射积分血管内超声（IB-IVUS）评估代谢综合征（MetS）对冠状动脉斑块组织特征的影响。
代谢综合征与心血管疾病风险增加相关。
我们根据成人治疗小组第三次报告（ATP III）标准中美国国家胆固醇教育计划的定义来确定代谢综合征。使用40兆赫（电动回撤速度0.5毫米/秒）血管内导管，通过传统和IB-IVUS参数测量轻度至中度狭窄的非靶冠状动脉病变。在每个斑块中，以0.5毫米的间隔记录总共20张IB-IVUS图像，长度为10毫米。使用商用软件进行三维分析。
在122例患者的148个病变中，代谢综合征的患病率为61例患者（50%），73个病变（49%）。代谢综合征患者的脂质面积百分比（38±19%对30±19%，p = 0.02）和脂质体积百分比（39±17%对33±17%，p = 0.03）显著增加，同时纤维体积百分比显著降低（57±14%对61±13%，p = 0.03）。在对潜在混杂风险因素进行调整后的多变量回归分析显示，代谢综合征仍与脂质体积百分比独立相关（r = 0.223，p = 0.01）。在对混杂因素和非代谢综合征冠状动脉危险因素进行调整后的逻辑回归分析显示，代谢综合征（优势比4.00，95%置信区间1.33至12.0，p = 0.01）被证明是富含脂质斑块的独立预测因子。
代谢综合征与富含脂质的斑块相关，导致斑块易损性风险增加。
