Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-17-6, Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
J Cardiol. 2012 Jan;59(1):42-9. doi: 10.1016/j.jjcc.2011.07.012. Epub 2011 Sep 3.
Previous epidemiological studies demonstrated plaque vulnerability to be high in diabetic patients. iMap-intravascular ultrasound (IVUS) is a recently developed radiofrequency 40 MHz IVUS imaging system for tissue characterization. This study aimed to characterize coronary plaque in target lesions of diabetic patients using iMap-IVUS.
We studied 175 treated vessels in 146 patients with stable angina pectoris and analyzed plaque components of culprit lesions by iMAP-IVUS. Patients were divided into 2 groups: non-diabetic (non-DM: 112 vessels, 93 patients) and diabetic (DM: 63 vessels, 53 patients).
In gray-scale IVUS 2D analysis, there were no differences in IVUS parameters. In 3D analysis, the DM group tended to have a larger plaque volume (p=0.07) and plaque burden (p=0.10). At minimum lumen sites, the absolute lipidic and necrotic areas (0.84 ± 0.44 mm(2) vs. 0.58 ± 0.41 mm(2), p<0.001, and 2.42 ± 1.65 mm(2) vs. 1.46 ± 1.76 mm(2), p<0.001, respectively) and percent lipidic and necrotic areas were significantly greater in the DM than in the non-DM group (8.39 ± 3.38% vs. 5.25 ± 2.30%, p<0.0001, and 23.65 ± 11.54% vs. 12.99 ± 10.71%, p<0.0001, respectively). In addition, the absolute lipidic and necrotic volumes (11.75 ± 10.59 mm(3) vs. 8.18 ± 6.24 mm(3), p<0.01, and 29.99 ± 28.90 mm(3) vs. 19.44 ± 19.35 mm(3), p<0.01, respectively) and percent lipidic and necrotic volumes were significantly greater in the DM than in the non-DM group (6.27 ± 1.92% vs. 5.13 ± 1.82%, p<0.0001, and 16.54 ± 7.56% vs. 12.08 ± 6.05%, p<0.0001, respectively).
Characterization of coronary plaque by iMAP-IVUS in diabetic patients showed increased lipidic amount and necrotic plaque volume relative to subjects without DM.
先前的流行病学研究表明，糖尿病患者的斑块易损性很高。iMap-血管内超声（IVUS）是一种最近开发的 40MHz 射频 IVUS 成像系统，用于组织特征描述。本研究旨在使用 iMap-IVUS 描述糖尿病患者的靶病变中的冠状动脉斑块。
我们研究了 146 例稳定型心绞痛患者的 175 个治疗血管，并通过 iMAP-IVUS 分析了罪犯病变的斑块成分。患者分为两组：非糖尿病组（非 DM：112 个血管，93 例）和糖尿病组（DM：63 个血管，53 例）。
在灰阶 IVUS 2D 分析中，两组 IVUS 参数无差异。在 3D 分析中，DM 组的斑块体积较大（p=0.07），斑块负荷较大（p=0.10）。在最小管腔部位，DM 组的脂质和坏死绝对面积（0.84±0.44mm²比 0.58±0.41mm²，p<0.001，2.42±1.65mm²比 1.46±1.76mm²，p<0.001）和脂质及坏死的百分比（8.39±3.38%比 5.25±2.30%，p<0.0001，23.65±11.54%比 12.99±10.71%，p<0.0001）均显著高于非 DM 组。此外，DM 组的脂质和坏死的绝对体积（11.75±10.59mm³比 8.18±6.24mm³，p<0.01，29.99±28.90mm³比 19.44±19.35mm³，p<0.01）和脂质及坏死的百分比（6.27±1.92%比 5.13±1.82%，p<0.0001，16.54±7.56%比 12.08±6.05%，p<0.0001）均显著高于非 DM 组。
与无糖尿病患者相比，糖尿病患者冠状动脉斑块的 iMap-IVUS 特征显示脂质含量增加，坏死斑块体积增大。
