title: Impact of radiofrequency catheter ablation on echocardiographic  and cardiopulmonary performance in patients with ventricular  extrasystolic beats and suspected arrhythmia-induced  cardiomyopathy.
abstract: Integrated backscatter intravascular ultrasound (IB-IVUS) is a useful method for analyzing coronary plaque tissue. We evaluated whether tissue composition determined using IB-IVUS is associated with the progression of stenosis in coronary angiography. Sixty-three nontarget coronary lesions in 63 patients with stable angina were evaluated using conventional IVUS and IB-IVUS. IB-IVUS images were analyzed at 1-mm intervals for a length of 10 mm. After calculating the relative areas of the tissue components using the IB-IVUS system, fibrous volume (FV) and lipid volume (LV) were calculated through integration of the slices, after which percentages of per-plaque volume (%FV/PV, %LV/PV) and per-vessel volume (%FV/VV, %LV/VV) were calculated. Progression of coronary stenosis was interpreted from the increase in percent diameter stenosis (%DS) from baseline to the follow-up period (6–9 months) using quantitative coronary angiography. %DS was 24.1 ± 12.8 % at baseline and 23.2 ± 13.7 % at follow-up. Using IB-IVUS, LV was 31.7 ± 10.5 mm3, and %LV/PV and %LV/VV were 45.6 ± 10.3 % and 20.2 ± 6.0 %, respectively. FV, %FV/PV, and %FV/VV were 35.5 ± 12.1 mm3, 52.1 ± 9.5 %, and 23.4 ± 7.1 %, respectively. The change in %DS was −0.88 ± 7.25 % and correlated closely with %LV/VV (r = 0.27, P = 0.03) on simple regression. Multivariate regression after adjustment for potentially confounding risk factors showed %LV/VV to be correlated independently with changes in %DS (r = 0.42, P = 0.02). Logistic regression analysis after adjusting for confounding coronary risk factors showed LV (odds ratio 1.08; 95 % confidence interval 1.01–1.16; P = 0.03) and %LV/VV (odds ratio 1.13; 95 % confidence interval 1.01–1.28; P = 0.03) to be independent predictors of the progression of angiographic coronary stenosis. Our findings suggest that angiographic luminal narrowing of the coronary artery is likely associated with tissue characteristics. IB-IVUS may provide information about the natural progression of luminal narrowing in coronary stenosis.
authors.affiliation: Department of Cardiology, Medical Center for Postgraduate Education, Grochowski Hospital, 04-073 Warsaw, Poland. tomasz.krynski@gmail.com
authors.forename: Tomasz
authors.initials: T
authors.lastname: Krynski
authors.forename: Sebastian
authors.initials: S
authors.lastname: Stec
authors.forename: Sebastian
authors.initials: S
authors.lastname: Szmit
authors.forename: Beata
authors.initials: B
authors.lastname: Zaborska
authors.forename: Paweł
authors.initials: P
authors.lastname: Balsam
authors.forename: Piotr
authors.initials: P
authors.lastname: Kulakowski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D017115:Catheter Ablation / Q000379:methods*; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy