Coronary arterial remodeling in differing clinical presentations of unstable angina pectoris--an intravascular ultrasound study.
BACKGROUND
Coronary arterial remodeling influences the clinical presentation of ischemic heart disease; however, there is little information on the relationship between coronary arterial remodeling and the type of angina pectoris that patients manifest.


OBJECTIVE
The study was undertaken to determine the difference of coronary arterial remodeling in patients with different types of angina pectoris.


METHODS
We analyzed 100 patients with ischemic heart disease using intravascular ultrasound (IVUS). Intracoronary IVUS images of proximal reference (PR), distal reference (DR), and target lesion were recorded, and intraluminal area (LA) and external elastic membrane (EEM) were measured. We defined a remodeling index as 100 x (lesion EEM - [PR-EEM + DR-EEM]/2) / ([PR-EEM + DR-EEM]/2). Cases were classified into three groups according to the clinical history (Group 1a: de novo unstable angina pectoris, Group 1b: accelerating unstable angina pectoris, and Group 2; stable angina pectoris).


RESULTS
The remodeling index in Group 1a was significantly larger than that in Groups 1b and 2 (18.6 +/- 28.5 vs. 5.3 +/- 27.1 and 18.6 +/- 28.5 vs. -2.7 +/- 17.6, p = 0.0347 and p = 0.0005, respectively), but there was no statistical difference in remodeling index between Groups 1b and 2.


CONCLUSIONS
Our results indicate that positive coronary arterial remodeling is more prevalent in patients with new onset of angina pectoris. The specific type of coronary arterial remodeling may affect the clinical presentation of patients with coronary artery disease.
Iwami
Takahiro
T
Division of Cardiology, Tokuyama Central Hospital, Tokuyama, Japan.
Nishioka
Toshihiko
T
Fishbein
Michael C
MC
Luo
Huai
H
Jeon
Doo-Soo
DS
Miyamoto
Takashi
T
Wakeyama
Takatoshi
T
Iida
Hiroshi
H
Takaki
Akira
A
Oda
Tetsuro
T
Mochizuki
Mamoru
M
Ogawa
Hiroshi
H
Siegel
Robert J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D020257:Ventricular Remodeling