title: Relationship between arterial and fibrous cap remodeling: a serial three-vessel intravascular ultrasound and optical coherence tomography study.
abstract: BACKGROUND
  Positive arterial remodeling and thin fibrous cap are characteristics of rupture-prone or vulnerable plaque. The natural course of the fibrous cap thickness and the relationship between serial arterial remodeling and changes in fibrous cap thickness are unknown. Therefore, the purpose of this study was to evaluate the relationship between changes in fibrous cap thickness and arterial remodeling by using optical coherence tomography (OCT) and intravascular ultrasound (IVUS) during 6-month follow-up.
  
  
  RESULTS
  Both IVUS and OCT examinations were performed on 108 vessels from 36 patients with ischemic heart disease who underwent percutaneous coronary intervention. Fifty-eight fibroatheromas were selected from 82 nonsignificant, nonculprit lesions (angiographic diameter stenosis, 25% to 75%; plaque burden, >40% by IVUS). Fibroatheroma was defined by OCT as lipid-rich plaque in >1 quadrant that has lipid. Thickness of the fibrous cap was measured by OCT. IVUS and OCT examinations were repeated at 6-month follow-up. Serial changes and relationships between IVUS indices and fibrous cap thickness were investigated. Overall, fibrous cap thickness (98.1±38.9 to 96.9±44.5 μm) as well as IVUS indices did not change significantly within 6 months. The percent changes in fibrous cap thickness correlated negatively and significantly (r=-0.54; P<0.0001; generalized estimating equation adjusted, r=-0.42; P=0.001) with the percent changes in external elastic membrane cross-sectional area.
  
  
  CONCLUSIONS
  Arterial remodeling is related to changes in fibrous cap thickness. Positive arterial remodeling is not only an adaptive process, but also related to thinning of the fibrous cap.
authors.affiliation: Division of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Yamada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Kume
authors.forename: Ken
authors.initials: K
authors.lastname: Saito
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Koichiro
authors.initials: K
authors.lastname: Imai
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Tomoko
authors.initials: T
authors.lastname: Maehama
authors.forename: Noriko
authors.initials: N
authors.lastname: Okahashi
authors.forename: Kikuko
authors.initials: K
authors.lastname: Obase
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashida
authors.forename: Yoji
authors.initials: Y
authors.lastname: Neishi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kawamoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D058426:Neointima; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000473:pathology; D011859:Radiography; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional