title: Comparative intravascular ultrasound analysis of ostial disease in the left main versus the right coronary artery.
abstract: BACKGROUND
  Significant aorto-ostial disease is difficult to evaluate with angiography and sometimes even with intravascular ultrasound (IVUS).
  
  
  METHODS
  We used IVUS to compare ostial lesions in the left main coronary (LMCA, n = 45) versus the right coronary artery (RCA, n = 50). IVUS measurements were performed each 1 mm beginning within the ostium and continuing to the distal reference segment. Negative remodeling was defined as a remodeling index (lesion/distal reference arterial area) < 0.95.
  
  
  RESULTS
  Patient age was 66 +/- 11 years in the LMCA group and 66 +/- 11 years in the RCA group; 56% of the LMCA ostial lesions and 46% of RCA ostial lesions were in males, and 35% of the LMCA ostial lesions and 20% of the RCA ostial lesions were in diabetics. With the exception of a smaller minimum lumen area (p < 0.0001) and distal reference plaque burden (p = 0.002) in ostial RCA lesions and a larger eccentricity index in ostial LMCA lesions (p = 0.001), both sites were remarkably similar. Both ostial LMCA and RCA lesions were short, had modest amounts of calcium, had modest plaque burdens, but had a marked frequency of negative remodeling (84% in LMCA and 86% in RCA; p = 1.0).
  
  
  CONCLUSIONS
  IVUS morphometry is similar in ostial LMCA and RCA lesions; negative remodeling is the dominant contributor to lumen compromise in both locations.
authors.affiliation: Cardiovascular Research Institute/Medstar Research Institute, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Kim
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.forename: Patrick
authors.initials: P
authors.lastname: Ohlmann
authors.forename: Salah-Eddine
authors.initials: SE
authors.lastname: Hassani
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Michalek
authors.forename: Esteban
authors.initials: E
authors.lastname: Escolar
authors.forename: Anh B
authors.initials: AB
authors.lastname: Bui
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kent
authors.forename: William O
authors.initials: WO
authors.lastname: Suddath
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Weissman
mesh_terms: D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional