Abstract

Background Conflicting data about correlation of plaque composition assessed by Virtual Histology (VH) and remodeling index (RI) have been reported. In this study, we sought to evaluate in a larger patient population, the relation between plaque morphology obtained by VH and arterial remodeling.

Methods and Results VH intravascular ultrasound was performed on 95 non-bifurcation native significant lesions (>75% stenosis) in 85 patients. Positive remodeling (defined as RI ≥ 1.05) was present in 28 lesions, whereas intermediate/negative remodeling (RI < 1.05) was present in 67 lesions. Compared to intermediate/negative remodeling, positive remodeling was associated with an increased frequency of ACS patients (52 % vs. 25 %, p = 0.017), and a greater plaque burden (78.3 ± 6.3 vs. 73.2 ± 6.8 %, p = 0.0011). At the minimal lumen site, necrotic core was significantly smaller in lesions with positive remodeling (median and IQR: 5.0 %, 2.2-11.0 %) than in lesions with intermediate/negative remodeling (median and IQR: 9.0 %, 4.0-16.0 %; p = 0.048). No differences in rate of thin-cap fibroatheroma or for the presence of multiple necrotic core layers were observed, and there were no statistical differences for fibrous, fibro-fatty, and dense calcium percent plaque area at the MLD or for the entire lesion length between both groups.

Conclusions In vivo VH analysis shows that lesions with positive remodeling have statistically less necrotic core percent area at the MLD site compared to intermediate/negative remodeling lesions.