Heart 1998;79:137-142 ( February )

Atherosclerotic coronary lesions with inadequate compensatory enlargement have smaller plaque and vessel volumes: observations with three dimensional intravascular ultrasound in vivo

C von Birgelen,^a G S Mintz,^c E A de Vrey,^c T Kimura,^b J J Popma,^c S G Airiian,^a M B Leon,^c M Nobuyoshi,^b P W Serruys,^a P J de Feyter^a

^a Thoraxcenter, University Hospital Rotterdam-Dijkzigt, Rotterdam, Netherlands, ^b Kokura Memorial Hospital, Kitakyushu, Japan, ^c Washington Hospital Center, Washington DC, USA

Correspondence to: Dr de Feyter, Thoraxcenter, Bd 381, PO Box 1738, University Hospital Rotterdam-Dijkzigt 3000 DR Rotterdam, Netherlands.

Accepted for publication 2 October 1997

ObjectiveTo compare vessel, lumen, and plaque volumes in atherosclerotic coronary lesions with inadequate compensatory enlargement versus lesions with adequate compensatory enlargement.
Design35 angiographically significant coronary lesions were examined by intravascular ultrasound (IVUS) during motorised transducer pullback. Segments 20 mm in length were analysed using a validated automated three dimensional analysis system. IVUS was used to classify lesions as having inadequate (group I) or adequate (group II) compensatory enlargement.
ResultsThere was no significant difference in quantitative angiographic measurements and the IVUS minimum lumen cross sectional area between groups I (n = 15) and II (n = 20). In group I, the vessel cross sectional area was 13.3 (3.0) mm² at the lesion site and 14.4 (3.6) mm² at the distal reference (p < 0.01), whereas in group II it was 17.5 (5.6) mm² at the lesion site and 14.0 (6.0) mm² at the distal reference (p < 0.001). Vessel and plaque cross sectional areas were significantly smaller in group I than in group II (13.3 (3.0) v 17.5 (5.6) mm², p < 0.01; and 10.9 (2.8) v 15.2 (4.9) mm², p < 0.005). Similarly, vessel and plaque volume were smaller in group I (291.0 (61.0) v 353.7 (110.0) mm³, and 177.5 (48.4) v 228.0 (92.8) mm³, p < 0.05 for both). Lumen areas and volumes were similar.
ConclusionsIn lesions with inadequate compensatory enlargement, both vessel and plaque volume appear to be smaller than in lesions with adequate compensatory enlargement.

Keywords: intravascular ultrasound;  ultrasonics;  remodelling;  coronary artery disease

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© 1998 by Heart
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