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通过虚拟组织学血管内超声评估稳定型心绞痛患者靶病变的循环微粒与冠状动脉斑块成分

Circulating Microparticles and Coronary Plaque Components Assessed by Virtual Histology Intravascular Ultrasound of the Target Lesion in Patients with Stable Angina.

作者信息

Min Pil-Ki, Cho Minhee, Hong Sung-Yu, Kim Jong-Youn, Choi Eui-Young, Yoon Young-Won, Lee Byoung Kwon, Hong Bum-Kee, Rim Se-Joong, Kwon Hyuck Moon

机构信息

Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.

出版信息

PLoS One. 2016 Jan 26;11(1):e0148128. doi: 10.1371/journal.pone.0148128. eCollection 2016.

Abstract

High levels of microparticles (MPs) circulate in the blood of patients with atherosclerotic diseases where they can serve as potential biomarkers of vascular injury and cardiovascular outcome. We used virtual histology intravascular ultrasound (VH-IVUS) to evaluate the relationship between the levels of circulating MPs and the coronary plaque composition in patients with stable angina. We included 35 patients with stable angina (22 men, age 64 ± 9 years) and a de novo target lesion. Preintervention gray-scale and VH-IVUS analysis was performed across the target lesion. Volumetric analysis was performed over a 10-mm-long segment centered at the minimum luminal site. Blood samples were obtained from the femoral artery before coronary angioplasty. MPs were measured using a solid-phase capture assay from a commercial kit. We divided participants into either a low MPs group or high MPs group based on the median value of MPs. There was no significant difference in baseline characteristics between the groups. The plaque burden and remodeling index were similar between the groups. The presence of VH-IVUS-derived thin-cap fibroatheroma was not different between the groups. The percentage of the necrotic core (NC) was significantly higher in the high MPs group than in the low MPs group, both in planar (17.0 ± 8.8% vs. 24.1 ± 6.9%, p = 0.012) and volumetric analyses (17.0 ± 4.8% vs. 22.1 ± 4.3%, p = 0.002). Circulating MPs were positively correlated with the percentage of the NC area at the minimal luminal site (r = 0.491, p = 0.003) and the percentage of the NC volume (r = 0.496, p = 0.002). Elevated levels of circulating MPs were associated with the amount of NC in the target lesion in those with stable angina, suggesting a potential role of circulating MPs as a biomarker for detecting unstable plaque in patients with stable angina.

摘要

在动脉粥样硬化疾病患者的血液中,高水平的微粒(MPs)会循环存在,它们可作为血管损伤和心血管疾病转归的潜在生物标志物。我们使用虚拟组织学血管内超声(VH-IVUS)来评估稳定型心绞痛患者循环MPs水平与冠状动脉斑块成分之间的关系。我们纳入了35例有初发靶病变的稳定型心绞痛患者(22例男性,年龄64±9岁)。在靶病变处进行干预前的灰阶和VH-IVUS分析。在以最小管腔部位为中心的10毫米长节段上进行容积分析。在冠状动脉血管成形术前从股动脉采集血样。使用商业试剂盒的固相捕获分析法测量MPs。我们根据MPs的中位数将参与者分为低MPs组或高MPs组。两组之间的基线特征无显著差异。两组之间的斑块负荷和重构指数相似。两组之间VH-IVUS衍生的薄帽纤维粥样瘤的存在情况无差异。无论是平面分析(17.0±8.8%对24.1±6.9%,p = 0.012)还是容积分析(17.0±4.8%对22.1±4.3%,p = 0.002),高MPs组坏死核心(NC)的百分比均显著高于低MPs组。循环MPs与最小管腔部位NC面积的百分比(r = 0.491,p = 0.003)和NC体积的百分比(r = 0.496,p = 0.002)呈正相关。稳定型心绞痛患者循环MPs水平升高与靶病变中NC的量相关,提示循环MPs作为检测稳定型心绞痛患者不稳定斑块生物标志物的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f2d/4727898/40475a945670/pone.0148128.g001.jpg

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