Remodeling index compared to actual vascular remodeling in atherosclerotic left main coronary arteries as assessed with long-term (> or =12 months) serial intravascular ultrasound.
OBJECTIVE
We present the remodeling index (RI) versus serial intravascular ultrasound (IVUS) data.


BACKGROUND
The RI, derived by comparing lesion external elastic membrane (EEM) cross-sectional area versus the reference at one time point, is used in various IVUS studies as a substitute of true remodeling (change in EEM over time), assuming that it represents true remodeling.


METHODS
We studied 46 non-stenotic left main arteries using serial IVUS (follow-up 18 +/- 8 months). Plaques were divided into subgroups according to the follow-up RI: follow-up RI >1 (n = 27) versus follow-up RI < or =1 (n = 19).


RESULTS
Lesions with a follow-up RI >1 had an increase in lumen despite an increase in plaque because of an increase in EEM. Conversely, lesions with a follow-up RI < or =1 had a reduction in lumen as a result of both a plaque increase and EEM decrease. Overall, the follow-up RI correlated directly with changes in lesion site EEM (baseline-to-follow-up). Although there was no correlation between the follow-up RI and changes in reference EEM area, changes in reference EEM area did correlate directly with changes in lesion EEM area. In nearly 90% of lesions with a follow-up RI >1, there was a previously documented increase in EEM area. Using multivariate linear regression analysis, the follow-up RI was dependent on the baseline RI, the increase in lesion EEM area, and the decrease in reference EEM area. The follow-up RI was not dependent on changes in lesion plaque area.


CONCLUSIONS
The vast majority of left main lesions with a remodeling index >1 had evidence of a previous increase in lesion-site EEM area.
von Birgelen
Clemens
C
Medisch Spectrum Twente, Department of Cardiology, Enschede, The Netherlands. von.birgelen@12move.nl
Hartmann
Marc
M
Mintz
Gary S
GS
Böse
Dirk
D
Eggebrecht
Holger
H
Neumann
Till
T
Gössl
Mario
M
Wieneke
Heinrich
H
Schmermund
Axel
A
Stoel
Martin G
MG
Verhorst
Patrick M J
PM
Erbel
Raimund
R
D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional / Q000379:methods*