Intravascular ultrasound study of coronary artery remodeling and plaque composition in patients with coronary atherosclerotic heart disease

Abstract

Objective To demonstrate the relationship between plaque composition and coronary artery remodeling in the same patient′s blood vessel. Methods A total of 48 coronary artery plaque were included in this study. Qualitative assessment and quantitative measurements of the lesion were performed in target lesions. The lesions were classified into soft plaque, fibrous plaque, calcified plaque and mixed plaque according to different degree of reflection of ultrasound signal. The remodeling index (RI) was defined as the ratio of external elastic membrane cross sectional area of lesion segment to the mean reference external elastic membrane cross sectional area. Results In comparison to hard plaque group, RI of soft plaque group was significantly larger in the same patient (1.08±0.15 vs 1.00±0.13, P=0.000). Soft plaque group presented with more positive remodeling than hard plaque group, but with P value more than 0.05 (83.3% vs 58.3%, P=0.057). The plaque area, lumen area and plaque burden were not different between two group (P>0.05). Conclusions The blood vessel was compensatively dilated in soft plaque segments and RI was significantly larger than in hard plaque segments. Coronary atherosclerotic vessel presented positive remodeling in the acute stage of inflammation. Key words: Endosonography; Coronary artery heart disease; Remodeling; Plaque; Atherosclerotic