Cardiovascular medicine
Size of emptied plaque cavity following spontaneous rupture is
related to coronary dimensions, not to the degree of lumen narrowing. A
study with intravascular ultrasound in vivo
C von Birgelena, W Klinkharta, G S Mintzb, H Wienekea, D Baumgarta, M Haudea, T Bartela, S Sacka, J Gea, R Erbela
a Department of
Cardiology, University Hospital Essen, Hufelandstr 55, D-45122 Essen,
Germany, b Washington Hospital
Center, Washington DC, USA
Correspondence to: Dr von Birgelen. von.birgelen{at}uni-essen.de
Accepted 31 July 2000
OBJECTIVE
To identify any potential
relations between the size of an emptied plaque cavity and the
remodelling pattern, plaque or vessel dimensions, lumen narrowing, and
other ultrasonic lesion characteristics.
DESIGNIntravascular ultrasound was
used to examine prospectively 51 ruptured ulcerated coronary
plaques. Cross sectional area measurements comprised lumen, vessel,
plaque, and emptied plaque cavity. Lumen narrowing was calculated as
1 
(lesion lumen area/reference lumen area) × 100%. A
remodelling index was calculated as lesion vessel area/reference vessel
area, and plaques were divided into those with values > 1.05 (group
A) and 
1.05 (group B).
RESULTSOf the total of 51 plaques,
36 (71%) were assigned to group A and 15 (29%) to group B. In neither
group was there a significant difference in reference dimensions and
lumen narrowing. However, lesion vessel (mean (SD): 22.6 (8.1)
mm2 v 17.5 (4.3)
mm2; p = 0.006) and plaque areas (15.8 (6.2)
mm2 v 12.8 (3.2)
mm2; p = 0.03) were greater in group A than in group B. The cavity inside the plaque was larger in group A than in group B (2.8 (1.6) mm2 v 1.8 (0.9)
mm2; p = 0.007) and showed a positive linear relation
with lesion and reference vessel size
(r = 0.58 and 0.56, respectively;
p < 0.001), but not with lumen narrowing.
CONCLUSIONSThe size of the emptied
cavity inside ruptured plaques is on average larger in lesions with
adaptive vascular remodelling, and shows a linear relation with lesion
plaque and vessel size and with the reference dimensions, but not with
the degree of lumen narrowing.
Keywords: intravascular ultrasound; ultrasonic scanning; plaque rupture; remodelling
© 2000 by Heart
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