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The most recent version of this article was published on 1 April 2008

Heart. Published Online First: 23 July 2007. doi:10.1136/hrt.2007.118950
Copyright © 2007 BMJ Publishing Group Ltd & British Cardiovascular Society

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Original articles

Plaque Characterization by Virtual Histology Intravascular Ultrasound Analysis in Type II Diabetic Patients

Kenya Nasu 1*, Etsuo Tsuchikane 1, Osamu Katoh 1, Hiroshi Fujita 1, Jean-Francois Surmely 1, Mariko Ehara 1, Yoshihisa Kinoshita 1, Nobuyoshi Tanaka 1, Tetsuo Matsubara 1, Yasushi Asakura 1, Keiko Asakura 1, Mitsuyasu Terashima 1 and Takahiko Suzuki 1

1 Toyohashi Heart Center, Japan

* To whom correspondence should be addressed. E-mail: yuya0728{at}m3.kcn.ne.jp.

Accepted 19 June 2007


*  Abstract

Objectives The purpose of this study was to evaluate the in-vivo plaque composition and characteristics in type II diabetes mellitus (DM) patients using Virtual HistologyTM intravascular ultrasound (VH IVUS).

Methods and Results In 90 stable angina pectoris patients, de novo target vessels were studied and plaque components were analyzed. Patients were divided into two groups: a diabetic group (36 vessels) and a non-diabetic group (54 vessels). The percent area of necrotic core and dense calcium were significantly larger in the DM group compared with the non-DM group [Necrotic core: 11.0% (interquartile range (IQR): 7.2 to 15.2%) vs. 7.6% (IQR: 5.6 to 13.2%), p = 0.03; Dense calcium: 5.6% (IQR: 2.3 to 7.3%) vs. 2.9% (IQR: 1.7 to 4.9%), p = 0.01]. The DM group presented with a significantly higher presence of at least one VH IVUS-derived thin-cap fibroatheroma (VHD-TCFA) [75% vs. 41%, p = 0.001] and VH IVUS-derived fibrocalcific atheroma (VHD-FCA) [75% vs. 40%, p = 0.001]. In the DM group, 53% of the vessels had both VHD-TCFA and VHD-FCA, which was significantly higher than non DM group (17%, p = 0.0004).

Conclusions Coronary plaque characteristics in DM patients showed an increased amount of dense calcium and necrotic core, as well as a higher frequency of VHD-TCFA and VHD-FCA. Atherosclerosis of the target vessel was more advanced in diabetic patients.


Keywords: Calcification, Diabetes mellitus, Virtual Histology, Vulnerable plaque







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