The Division of Cardiovascular Disease, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Atherosclerosis. 2012 Aug;223(2):365-71. doi: 10.1016/j.atherosclerosis.2012.05.023. Epub 2012 May 31.
Few studies have examined plaque characteristics among multiple arterial beds in vivo. The purpose of this study was to compare the plaque morphology and arterial remodeling between coronary and peripheral arteries using gray-scale and radiofrequency intravascular ultrasound (IVUS) at clinical presentation.
IVUS imaging was performed in 68 patients with coronary and 93 with peripheral artery lesions (29 carotid, 50 renal, and 14 iliac arteries). Plaques were classified as fibroatheroma (VH-FA) (further subclassified as thin-capped [VH-TCFA] and thick-capped [VH-ThCFA]), fibrocalcific plaque (VH-FC) and pathological intimal thickening (VH-PIT). Plaque rupture (13% of coronary, 7% of carotid, 6% of renal, and 7% of iliac arteries; P = NS) and VH-TCFA (37% of coronary, 24% of carotid, 16% of renal, and 7% of iliac arteries; P = 0.02) were observed in all arteries. Compared with coronary arteries, VH-FA was less frequently observed in renal (P < 0.001) and iliac arteries (P < 0.006). Lesions with positive remodeling demonstrated more characteristics of VH-FA in coronary (84% vs. 25%, P < 0.001), carotid (72% vs. 20%, P = 0.001), and renal arteries (42% vs. 4%, P = 0.001) compared with those with intermediate/negative remodeling. There was positive relationship between remodeling index and percent necrotic area in all four arteries.
Atherosclerotic plaque phenotypes were heterogeneous among four different arteries; renal and iliac arteries had more stable phenotypes compared with coronary artery. In contrast, the associations of remodeling pattern with plaque phenotype and composition were similar among the various arterial beds.
很少有研究在体内检查多个动脉床的斑块特征。本研究旨在通过临床检查比较冠状动脉和外周动脉的斑块形态和动脉重构，采用灰阶和射频血管内超声（IVUS）。
对 68 例冠状动脉病变和 93 例外周动脉病变患者（29 例颈动脉、50 例肾动脉和 14 例髂动脉）进行 IVUS 成像。将斑块分为纤维粥样瘤（VH-FA）（进一步细分为薄帽纤维粥样瘤[VH-TCFA]和厚帽纤维粥样瘤[VH-ThCFA]）、纤维钙化斑块（VH-FC）和病理性内膜增厚（VH-PIT）。斑块破裂（冠状动脉 13%、颈动脉 7%、肾动脉 6%和髂动脉 7%；P=NS）和 VH-TCFA（冠状动脉 37%、颈动脉 24%、肾动脉 16%和髂动脉 7%；P=0.02）在所有动脉中均可见。与冠状动脉相比，VH-FA 在肾动脉（P<0.001）和髂动脉（P<0.006）中较少见。正性重构的病变在冠状动脉（84%对 25%，P<0.001）、颈动脉（72%对 20%，P=0.001）和肾动脉（42%对 4%，P=0.001）中具有更多 VH-FA 的特征。在所有 4 种动脉中，重构指数与坏死面积百分比呈正相关。
四种不同动脉的动脉粥样硬化斑块表型存在异质性；与冠状动脉相比，肾动脉和髂动脉的表型更稳定。相比之下，在各种动脉床中，重构模式与斑块表型和成分的相关性相似。
