Iwama Makoto, Tanaka Shinichiro, Noda Toshiyuki, Segawa Tomonori, Kawasaki Masanori, Nishigaki Kazuhiko, Minagawa Taro, Watanabe Sachiro, Minatoguchi Shinya
The Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan.
Heart Vessels. 2014 Nov;29(6):750-60. doi: 10.1007/s00380-013-0428-9. Epub 2013 Oct 24.
Integrated backscatter intravascular ultrasound (IB-IVUS) is a useful method for analyzing coronary plaque tissue. We evaluated whether tissue composition determined using IB-IVUS is associated with the progression of stenosis in coronary angiography. Sixty-three nontarget coronary lesions in 63 patients with stable angina were evaluated using conventional IVUS and IB-IVUS. IB-IVUS images were analyzed at 1-mm intervals for a length of 10 mm. After calculating the relative areas of the tissue components using the IB-IVUS system, fibrous volume (FV) and lipid volume (LV) were calculated through integration of the slices, after which percentages of per-plaque volume (%FV/PV, %LV/PV) and per-vessel volume (%FV/VV, %LV/VV) were calculated. Progression of coronary stenosis was interpreted from the increase in percent diameter stenosis (%DS) from baseline to the follow-up period (6-9 months) using quantitative coronary angiography. %DS was 24.1 ± 12.8 % at baseline and 23.2 ± 13.7 % at follow-up. Using IB-IVUS, LV was 31.7 ± 10.5 mm(3), and %LV/PV and %LV/VV were 45.6 ± 10.3 % and 20.2 ± 6.0 %, respectively. FV, %FV/PV, and %FV/VV were 35.5 ± 12.1 mm(3), 52.1 ± 9.5 %, and 23.4 ± 7.1 %, respectively. The change in %DS was -0.88 ± 7.25 % and correlated closely with %LV/VV (r = 0.27, P = 0.03) on simple regression. Multivariate regression after adjustment for potentially confounding risk factors showed %LV/VV to be correlated independently with changes in %DS (r = 0.42, P = 0.02). Logistic regression analysis after adjusting for confounding coronary risk factors showed LV (odds ratio 1.08; 95 % confidence interval 1.01-1.16; P = 0.03) and %LV/VV (odds ratio 1.13; 95 % confidence interval 1.01-1.28; P = 0.03) to be independent predictors of the progression of angiographic coronary stenosis. Our findings suggest that angiographic luminal narrowing of the coronary artery is likely associated with tissue characteristics. IB-IVUS may provide information about the natural progression of luminal narrowing in coronary stenosis.
背向散射积分血管内超声（IB-IVUS）是分析冠状动脉斑块组织的一种有用方法。我们评估了使用IB-IVUS确定的组织成分是否与冠状动脉造影中狭窄的进展相关。对63例稳定型心绞痛患者的63个非靶冠状动脉病变进行了传统IVUS和IB-IVUS评估。以1毫米的间隔分析IB-IVUS图像，长度为10毫米。使用IB-IVUS系统计算组织成分的相对面积后，通过切片积分计算纤维体积（FV）和脂质体积（LV），然后计算每个斑块体积的百分比（%FV/PV，%LV/PV）和每个血管体积的百分比（%FV/VV，%LV/VV）。使用定量冠状动脉造影从基线到随访期（6 - 9个月）直径狭窄百分比（%DS）的增加来解释冠状动脉狭窄的进展。基线时%DS为24.1±12.8%，随访时为23.2±13.7%。使用IB-IVUS，LV为31.7±10.5立方毫米，%LV/PV和%LV/VV分别为45.6±10.3%和20.2±6.0%。FV、%FV/PV和%FV/VV分别为35.5±12.1立方毫米、52.1±9.5%和23.4±7.1%。%DS的变化为-0.88±7.25%，在简单回归中与%LV/VV密切相关（r = 0.27，P = 0.03）。在对潜在混杂风险因素进行调整后的多变量回归显示，%LV/VV与%DS的变化独立相关（r = 0.42，P = 0.02）。在调整混杂的冠状动脉风险因素后的逻辑回归分析显示，LV（比值比1.08；95%置信区间1.01 - 1.16；P = 0.03）和%LV/VV（比值比1.13；95%置信区间1.01 - 1.28；P = 0.03）是冠状动脉造影狭窄进展的独立预测因素。我们的研究结果表明，冠状动脉造影的管腔狭窄可能与组织特征相关。IB-IVUS可能提供有关冠状动脉狭窄管腔狭窄自然进展的信息。
