Elghawaby Helmy Hassan, Shawky Mohamed Ashraf, Mowafi Ahmed Hossam, Abd-Elbary Akram Mohamed, Faris Farouk Mostafa
Critical Care Medicine, Faculty of Medicine, Cairo University, Egypt.
Egypt Heart J. 2018 Mar;70(1):9-14. doi: 10.1016/j.ehj.2017.05.003. Epub 2017 Jun 16.
Disruption of vulnerable plaques is the most common cause of acute coronary syndromes. Intravascular ultrasound facilitates cross-sectional imaging of coronary arteries. We aimed at using IVUS to investigate the morphology and tissue characteristics of atherosclerotic plaques of non-culprit intermediate coronary lesions in non-ST elevation ACS setting.
IVUS assessment of sixty-one intermediate coronary lesions in twenty-eight patients with the diagnosis of Non ST elevation acute coronary syndromes. Ultrasound signals were obtained by an IVUS system using a 40-MHz catheter.
Mean age was 53.2 ± 9.1 years. Males = 20 (71.4%). Smoking in 17 (60.7%), hypertension in 16 (57.1%), Dyslipidemia in 12 (42.9%) and DM in 8 (28.6%). Culprit vessels represent 42% of affected vessels. Sixty-one intermediate lesions were detected. Twenty-nine lesions in culprit vessels and thirty-two lesions in non-culprit vessels with higher lipidic content in lesions of culprit vessels ( < 0.001) while a higher calcific content in lesions of non-culprit vessels ( < 0.001). Higher calcific content of proximal more than distal lesions ( = 0.048). Negative remodeling in 55.7% of lesions.
A higher lipidic content in lesions of culprit vessels, while the lesions of non-culprit vessels were more calcific. Higher calcific content of proximal more than distal lesions was defined as well.
易损斑块破裂是急性冠状动脉综合征最常见的病因。血管内超声有助于冠状动脉的横断面成像。我们旨在使用血管内超声研究非ST段抬高型急性冠状动脉综合征（ACS）患者中，非罪犯相关的中度冠状动脉病变的动脉粥样硬化斑块的形态和组织特征。
对28例诊断为非ST段抬高型急性冠状动脉综合征的患者的61处中度冠状动脉病变进行血管内超声评估。使用40MHz导管的血管内超声系统获取超声信号。
平均年龄为53.2±9.1岁。男性20例（71.4%）。17例（60.7%）吸烟，16例（57.1%）高血压，12例（42.9%）血脂异常，8例（28.6%）糖尿病。罪犯血管占受累血管的42%。共检测到61处中度病变。罪犯血管中有29处病变，非罪犯血管中有32处病变，罪犯血管病变中的脂质含量更高（<0.001），而非罪犯血管病变中的钙化含量更高（<0.001）。近端病变的钙化含量高于远端病变（=0.048）。55.7%的病变存在负性重构。
罪犯血管病变中的脂质含量更高，而非罪犯血管病变的钙化程度更高。近端病变的钙化含量高于远端病变也得到了明确。
