Plaque location in the left anterior descending coronary artery and tissue characteristics in angina pectoris: an integrated backscatter intravascular ultrasound study.
BACKGROUND
Ruptured plaque and culprit lesions associated with anterior acute myocardial infarction cluster mainly in the proximal segment of the left anterior descending coronary artery (LAD). This study investigated whether the tissue characteristics of plaque in the proximal LAD differs from that of plaque in the distal LAD as assessed by integrated backscatter (IB)-intravascular ultrasound (IVUS).


RESULTS
IVUS interrogation was used to study 107 non-culprit intermediate plaques in 68 patients with angina pectoris who underwent percutaneous coronary interventions. Proximal and distal segments were defined as <30 mm and > or =30 mm from the ostium, respectively. IB-IVUS images were recorded, and the average percentage values of each plaque component (lipid, fibrosis, dense fibrosis, and calcification) were compared between segments. Plaques in the proximal segment (n=51) had a higher %lipid content (36 vs 19%, P<0.01) and a lower %fibrosis content (57 vs 64%, P<0.01) than did plaques in the distal segment (n=56). Multiple linear regression analysis showed that proximal plaques had a higher %lipid content, independently of other coronary risk factors and plaque burden (P<0.01).


CONCLUSIONS
The %lipid and %fibrosis contents differ significantly between plaques in the proximal segment and those in the distal segment of the LAD. (Circ J 2010; 74: 142 - 147).
Komura
Naohiro
N
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Hibi
Kiyoshi
K
Kusama
Ikuyoshi
I
Otsuka
Fumiyuki
F
Mitsuhashi
Takayuki
T
Endo
Mitsuaki
M
Iwahashi
Noriaki
N
Okuda
Jun
J
Tsukahara
Kengo
K
Kosuge
Masami
M
Ebina
Toshiaki
T
Umemura
Satoshi
S
Kimura
Kazuo
K
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D005355:Fibrosis; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*