Coronary artery remodelling is related to plaque composition

Gastón A. Rodriguez-Granillo ¹, Patrick W. Serruys ^1*, Hóctor M. García-García ¹, Jiro Aoki ¹, Marco Valgimigli ¹, Carlos A.G. van Mieghem ¹, Eugene Mc Fadden ¹, Peter P. de Jaegere ¹ and Pim de Feyter ¹

¹ Thoraxcenter, Erasmus MC, Netherlands

^* To whom correspondence should be addressed. E-mail: p.w.j.c.serruys{at}erasmusmc.nl.

Accepted 13 June 2005

Abstract

Background: Arterial remodelling has been related to clinical presentation and positively remodelled plaques have previously shown typical features of plaque vulnerability.

Objective: To assess the potential relationship between plaque composition and vascular remodelling using spectral analysis of IVUS radiofrequency data.

Methods and results: Forty-one coronary vessels with non-significant (<50 % diameter stenosis by angiography), ±20 mm, non-ostial lesions located in non-culprit vessels underwent IVUS interrogation. Spectral analysis of intravascular ultrasound radiofrequency data, obtained with a 30 MHz catheter, was performed with IVUS-Virtual Histology^TM software. Remodelling index (RI) was calculated and divided into 3 groups. Lesions with RI 1.05 were considered to have positive remodelling and lesions with RI 0.95 were considered to have negative remodelling. Lesions with RI 1.05 showed significantly larger lipid core than lesions with RI 0.96-104 and RI 0.95 respectively (22.1±6.3 vs. 15.1±7.6 vs. 6.6±6.9, p<0.0001). There was also a significant positive correlation between lipid core and RI (r=0.83, p=0.0001) and a statistically significant inverse correlation between fibrous tissue and RI (r=-0.45, p=0.003). Thin-cap fibroatheroma (TCFA) and fibroatheromatous lesions comprised 100% of the positively remodelled lesions, whereas negatively remodelled lesions presented a more stable phenotype, with 64% of pathological intimal thickening, 29% of fibrocalcific and only 7% of fibroatheromatous lesions (p<0.0001).

Conclusions: In this study, in vivo plaque composition and morphology assessed using spectral analysis of IVUS radiofrequency data was related to coronary artery remodelling.

Keywords: atherosclerosis, plaque characterization, remodeling, ultrasonography

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