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体内光学相干断层扫描检测人动脉粥样硬化性冠状动脉内膜内微血管的临床意义:多模态血管内成像研究。

Clinical significance of microvessels detected by in vivo optical coherence tomography within human atherosclerotic coronary arterial intima: a study with multimodality intravascular imagings.

机构信息

Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.

出版信息

Heart Vessels. 2021 Jun;36(6):756-765. doi: 10.1007/s00380-020-01756-0. Epub 2021 Jan 6.

DOI:10.1007/s00380-020-01756-0
PMID:33403471
Abstract

The significance of microvessels within atherosclerotic plaques is not yet fully clarified. Associated with plaque vulnerability. The aim of this study is to examine tissue characteristics of plaque with microvessels detected by optical coherence tomography (OCT) by use of a commercially available color-coded intravascular ultrasound (IVUS) and coronary angioscopy (CAS). The subjects examined comprised of 44 patients with stable angina pectoris who underwent percutaneous coronary intervention. Microvessels were defined as a tiny tubule with a diameter of 50-300 µm detected over three or more frames in OCT. We compared the total volume of microvessels with tissue component such as fibrotic, lipidic, necrotic, and calcified volume and the number of yellow plaque. In IVUS analysis, % necrotic volume and % lipidic volume were significantly correlated and % fibrotic volume was inversely significantly correlated with the total volume of microvessel (r = 0.485, p = 0.0009; r = 0.401, p = 0.007; r = - 0.432, p = 0.003, respectively). The number of plaque with an angioscopic yellow grade of two or more was significantly correlated with the total volume of microvessel (r = 0.461, p = 0.002). The greater the luminal volume of microvessels, the more the percent content of necrotic/lipidic tissue volume within plaque and the more the number of yellow plaques. These data suggested that microvessels within coronary plaque might be related to plaque vulnerability.

摘要

动脉粥样硬化斑块内微血管的意义尚不完全清楚。与斑块易损性相关。本研究旨在通过使用商用彩色编码血管内超声(IVUS)和冠状动脉血管镜(CAS)检查光学相干断层扫描(OCT)检测到的斑块内微血管的组织特征。检查对象包括 44 名稳定型心绞痛患者,他们接受了经皮冠状动脉介入治疗。微血管定义为在 OCT 上检测到的直径为 50-300µm 的微小管状结构,在三个或更多帧中检测到。我们比较了微血管的总体积与组织成分(如纤维化、脂质、坏死和钙化体积)以及黄色斑块的数量。在 IVUS 分析中,%坏死体积和%脂质体积呈显著正相关,%纤维化体积与微血管总体积呈显著负相关(r=0.485,p=0.0009;r=0.401,p=0.007;r=-0.432,p=0.003)。血管镜下黄色分级为 2 级或 2 级以上的斑块数量与微血管总体积呈显著正相关(r=0.461,p=0.002)。血管内腔中微血管的体积越大,斑块内坏死/脂质组织体积的百分比越高,黄色斑块的数量越多。这些数据表明,冠状动脉斑块内的微血管可能与斑块易损性有关。

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