[血管内超声扫描评估左前降支冠状动脉分叉远端的斑块分布]

[Intravascular ultrasound scanning assessment of plaque distribution in the left anterior descending coronary artery just distal to the bifurcation].

作者信息

Watanabe H, Yoshikawa J, Yoshida K, Akasaka T, Hozumi T, Takagi T, Honda Y, Okura H, Yamamuro A

机构信息

Department of Cardiology, Kobe General Hospital.

出版信息

J Cardiol. 1995 Dec;26(6):325-9.

PMID:8558410

Abstract

Coronary plaque has a distinct spatial distribution with the peak incidence on the outer wall around the bifurcation of the left main coronary artery. Intravascular ultrasound scanning was used to evaluate the distribution of the plaque in the proximal site of the left anterior descending coronary artery in 16 patients. Coronary angiography showed the examined sites were normal in all patients. A cross-sectional coronary scan was recorded in the left anterior descending coronary artery just distal to the bifurcation using a 4.3 Fr, 30 MHz intravascular ultrasound catheter. The thickness of the plaque was measured at 0, 90, 180, and 270 degrees, where 0 degree indicates the left circumflex coronary artery branching direction. The scan was divided into four areas of 90 degrees and labeled 1 to 4 in the counterclockwise direction (site 1 was the left circumflex coronary artery branching direction). The thickness and area of the plaque were measured in each site. The percentage plaque fraction was calculated as (plaque area in each site)/(plaque area of all) x 100. In 15 (94%) of the 16 patients, images of crescent shaped plaques were obtained. The mean thicknesses of the plaque at sites 1-4 were 0.25 +/- 0.07 mm, 0.46 +/- 0.21 mm, 0.82 +/- 0.19 mm, and 0.42 +/- 0.23 mm, respectively. The mean percentage plaque fractions were 7.9 +/- 3.6% (site 1), 18.1 +/- 7.2% (site 2), 55.0 +/- 8.1% (site 3), 18.7 +/- 6.9% (site 4), respectively. In site 3, opposite to the left circumflex coronary artery branching, the thickness and percentage plaque fraction were significantly greater than the remaining three sites (p < 0.001). In vivo intravascular ultrasound scanning revealed that coronary plaque in angiographically normal left anterior descending coronary artery just distal to the bifurcation has a distinct distribution with a peak incidence opposite to the left circumflex coronary artery branching.

摘要

冠状动脉斑块具有独特的空间分布，在左主冠状动脉分叉处周围的外壁上发病率最高。使用血管内超声扫描评估了16例患者左前降支冠状动脉近端部位斑块的分布情况。冠状动脉造影显示所有患者的检查部位均正常。使用4.3 Fr、30 MHz的血管内超声导管在左前降支冠状动脉分叉远端处记录横断面冠状动脉扫描图像。在0、90、180和270度处测量斑块厚度，其中0度表示左旋支冠状动脉分支方向。扫描被分为四个90度的区域，并按逆时针方向标记为1至4（部位1为左旋支冠状动脉分支方向）。在每个部位测量斑块的厚度和面积。斑块分数百分比计算为（每个部位的斑块面积）/（所有部位的斑块面积）×100。16例患者中有15例（94%）获得了新月形斑块图像。部位1至4的斑块平均厚度分别为0.25±0.07毫米、0.46±0.21毫米、0.82±0.19毫米和0.42±0.23毫米。斑块分数平均百分比分别为7.9±3.6%（部位1）、18.1±7.2%（部位2）、55.0±8.1%（部位3）、18.7±6.9%（部位4）。在与左旋支冠状动脉分支相对的部位3，斑块厚度和斑块分数百分比显著大于其余三个部位（p<0.001）。体内血管内超声扫描显示，在造影正常的左前降支冠状动脉分叉远端处的冠状动脉斑块具有独特的分布，在与左旋支冠状动脉分支相对的部位发病率最高。