title: Acute myocardial infarction: clinical characteristics and plaque morphology between expansive remodeling and constrictive remodeling by intravascular ultrasound.
abstract: BACKGROUND
  According to recent intravascular ultrasound (IVUS) studies, expansive remodeling (ER) at the culprit lesion has been observed in almost 50% of patients with acute coronary syndrome and constrictive remodeling (CR) in 30%. The purpose of this study is to investigate the difference between ER and CR at the culprit lesion in patients with acute myocardial infarction (AMI).
  
  
  RESULTS
  Preinterventional IVUS images of 73 patients with AMI were identified. The remodeling index (RI) was defined as the ratio of the external elastic membrane (EEM) areas at the culprit lesion to the EEM areas at the proximal reference site. Expansive remodeling was defined as an RI > 1.05; CR, as an RI < 0.95. In patients with AMI, 40 patients (55%) showed ER on IVUS, whereas CR was observed in 18 patients (25%). Patients with ER were significantly older than those with CR (P < .005). The frequency of the presence of calcifications was higher in patients with ER than in those with CR (P < .0005). In patients with AMI with ER, soft plaque with small calcium was the most frequent (58%). Multivariate analysis revealed that age and the presence of calcifications remained as independent predictors of ER.
  
  
  CONCLUSIONS
  These findings suggest that ER relates to old age and calcification, and CR may contribute to early plaque progression than ER in patients with AMI.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ehara
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Toru
authors.initials: T
authors.lastname: Kataoka
authors.forename: Hajime
authors.initials: H
authors.lastname: Yamashita
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nishioka
authors.forename: Koichiro
authors.initials: K
authors.lastname: Asawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamagishi
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
authors.forename: Makiko
authors.initials: M
authors.lastname: Ueda
mesh_terms: D000367:Age Factors; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D012044:Regression Analysis; D018709:Statistics, Nonparametric