Tissue characterisation of atherosclerotic plaque in coronary artery bifurcations: an intravascular ultrasound radiofrequency data analysis in humans.
OBJECTIVE
To investigate tissue characteristics of atherosclerotic plaques in coronary artery bifurcations.


RESULTS
Using a global virtual histology registry, geometric and compositional characteristics of plaque in three segments (proximal, distal, and at the bifurcation) of coronary bifurcation sites were analysed with intravascular ultrasound radiofrequency data (RFD) analysis. A total of 256 bifurcation sites were analysed: left main (LM)-left anterior descending artery (LAD), 41; LAD-diagonal artery, 128; left circumflex artery-obtuse marginal artery, 34; and right coronary artery-acute marginal artery, 53. The plaque+media (P+M) burden was larger in the distal segments of LM-LAD bifurcation sites than in the proximal and at the bifurcation segments (46.55±12.08% vs. 40.40±11.76%, 41.15±11.01%, p<0.001). The % necrotic core (NC) and % dense calcium (DC) at the bifurcation and distal segments of LM-LAD bifurcation sites was significantly greater than in the proximal segments (6.75±5.09%, 7.36±6.01% vs. 4.89±4.78%, p<0.05, and 3.31±2.87%, 3.73±3.28% vs. 1.89±2.10%, p<0.001). In contrast, P+M burden, % NC and % DC in the proximal segments of non-LM bifurcation sites was significantly greater than at the bifurcation and distal segments (49.41±12.12% vs. 45.34±11.21%, 46.80±10.68% / 8.08±6.21% vs. 6.47±5.11%, 6.28±5.05% / 4.57±4.67% vs. 3.38±3.44%, 3.55±3.74%, all p<0.001).


CONCLUSIONS
The results demonstrate that heterogeneous nature of coronary atherosclerosis at coronary bifurcations according to their segments and anatomical locations (LM-LAD vs. non-LM bifurcations). The further investigation for the clinical efficacy of the RFD analysis on bifurcation sites are warranted.
Han
Seung Hwan
SH
Gil Hospital, Gachon University of Medicine and Science, Incheon, South Korea.
Puma
Joseph
J
García-García
Hector M
HM
Nasu
Kenya
K
Margolis
Pauliina
P
Leon
Martin B
MB
Lerman
Amir
A
D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional / Q000379:methods*