Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
Cardiol Res Pract. 2011;2011:687515. doi: 10.4061/2011/687515. Epub 2011 Sep 15.
Background. Recent intravascular ultrasound (IVUS) studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such "attenuated plaque" may be an IVUS characteristic of unstable lesion. Methods. We used optical coherence tomography (OCT) in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque. Results. IVUS-detected attenuated plaque was observed in 41 (39%) patients. OCT-detected lipidic plaque (88% versus 49%, P < 0.001), thin-cap fibroatheroma (48% versus 16%, P < 0.001), plaque rupture (44% versus 11%, P < 0.001), and intracoronary thrombus (54% versus 17%, P < 0.001) were more often seen in IVUS-detected attenuated plaques compared with nonattenuated plaques. Conclusions. IVUS-detected attenuated plaque has many characteristics of unstable coronary lesion. The presence of attended plaque might be an important marker of lesion instability.
最近的血管内超声（IVUS）研究表明，尽管没有明亮的钙，但存在深部超声衰减的低回声斑块在急性冠脉综合征中很常见。这种“衰减斑块”可能是不稳定病变的 IVUS 特征。方法：我们使用光学相干断层扫描（OCT）对 104 例不稳定型心绞痛患者进行检查，比较 IVUS 检测到的衰减斑块与非衰减斑块的病变特征。结果：41 例（39%）患者观察到 IVUS 检测到的衰减斑块。OCT 检测到脂质斑块（88%对 49%，P<0.001）、薄帽纤维粥样斑块（48%对 16%，P<0.001）、斑块破裂（44%对 11%，P<0.001）和冠状动脉内血栓（54%对 17%，P<0.001）在 IVUS 检测到的衰减斑块中更为常见。结论：IVUS 检测到的衰减斑块具有许多不稳定冠状动脉病变的特征。衰减斑块的存在可能是病变不稳定的重要标志物。
