Longitudinal heterogeneity of coronary artery distensibility in plaques related to acute coronary syndrome.
BACKGROUND
How coronary distensibility contributes to stable or unstable clinical manifestations remains obscure. We postulated that the heterogeneous plaque distensibility is associated with unstable clinical presentations in patients with acute coronary syndrome (ACS).


RESULTS
Seventeen and 19 ACS-related and -unrelated lesions, respectively, were visualized using intravascular ultrasound imaging with simultaneous intracoronary pressure recording. Systolic and diastolic lumen cross-sectional areas were measured at the lesion site and at five evenly spaced sites between the proximal and distal reference sites. The coronary distensibility index and stiffness index β were calculated for each site and averaged for each coronary segment. Maximal distensibility index, standard deviation and the difference between maximal and minimal distensibility indices within each segment were significantly higher in the ACS-related than -unrelated plaques (5.6 ± 2.3 vs. 3.7 ± 1.8, p < 0.001, 2.1 ± 0.9 vs. 1.1 ± 0.6, p < 0.001 and 5.3 ± 2.3 vs. 2.8 ± 1.5, p < 0.001, respectively). Moreover, the difference in the distensibility index between the lesion site of ACS-related plaques and the immediate proximal site was significantly larger (2.88 ± 2.35 vs. 1.17 ± 1.44, p = 0.022) than that in ACS-unrelated plaques.


CONCLUSIONS
Coronary artery distensibility is longitudinally more heterogeneous in ACS-related than-unrelated plaques, especially between the lesion and the immediate proximal site.
Division of Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Osamu
O
Sasaki
Toshihiko
T
Nishioka
Yoshiro
Y
Inoue
Ami
A
Isshiki
Takashi
T
Akima
Kentarou
K
Toyama
Aki
A
Koike
Toshiyuki
T
Ando
Mikio
M
Yuhara
Shun-ichi
S
Sato
Tetsuo
T
Kamiyama
Masato
M
Kirimura
Hiroyuki
H
Ito
Yoshiaki
Y
Maruyama
Nobuo
N
Yoshimoto
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D000368:Aged; D000704:Analysis of Variance; D000787:Angina Pectoris / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D001794:Blood Pressure; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D018084:Ultrasonography, Interventional; D059289:Vascular Stiffness