Plaque characteristics and arterial remodeling in coronary and peripheral arterial systems.
BACKGROUND
Few studies have examined plaque characteristics among multiple arterial beds in vivo. The purpose of this study was to compare the plaque morphology and arterial remodeling between coronary and peripheral arteries using gray-scale and radiofrequency intravascular ultrasound (IVUS) at clinical presentation.


RESULTS
IVUS imaging was performed in 68 patients with coronary and 93 with peripheral artery lesions (29 carotid, 50 renal, and 14 iliac arteries). Plaques were classified as fibroatheroma (VH-FA) (further subclassified as thin-capped [VH-TCFA] and thick-capped [VH-ThCFA]), fibrocalcific plaque (VH-FC) and pathological intimal thickening (VH-PIT). Plaque rupture (13% of coronary, 7% of carotid, 6% of renal, and 7% of iliac arteries; P = NS) and VH-TCFA (37% of coronary, 24% of carotid, 16% of renal, and 7% of iliac arteries; P = 0.02) were observed in all arteries. Compared with coronary arteries, VH-FA was less frequently observed in renal (P < 0.001) and iliac arteries (P < 0.006). Lesions with positive remodeling demonstrated more characteristics of VH-FA in coronary (84% vs. 25%, P < 0.001), carotid (72% vs. 20%, P = 0.001), and renal arteries (42% vs. 4%, P = 0.001) compared with those with intermediate/negative remodeling. There was positive relationship between remodeling index and percent necrotic area in all four arteries.


CONCLUSIONS
Atherosclerotic plaque phenotypes were heterogeneous among four different arteries; renal and iliac arteries had more stable phenotypes compared with coronary artery. In contrast, the associations of remodeling pattern with plaque phenotype and composition were similar among the various arterial beds.
The Division of Cardiovascular Disease, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Yoshiki
Y
Matsuo
Takuro
T
Takumi
Verghese
V
Mathew
Woo-Young
WY
Chung
Gregory W
GW
Barsness
Charanjit S
CS
Rihal
Rajiv
R
Gulati
Eric T
ET
McCue
David R
DR
Holmes
Eric
E
Eeckhout
Ryan J
RJ
Lennon
Lilach O
LO
Lerman
Amir
A
Lerman
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005355:Fibrosis; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009336:Necrosis; D058426:Neointima; D010641:Phenotype; D058226:Plaque, Atherosclerotic; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000473:pathology