title: In vivo assessment of vasa vasorum neovascularization using intravascular ultrasound: A comparison between acute coronary syndrome and stable angina pectoris.
abstract: Previous studies have suggested that vasa vasorum (VV) neovascularization plays an important role in the progression and vulnerability of coronary atherosclerotic plaque.
  
  
  
  A total of 130 patients with coronary artery disease including 75 acute coronary syndrome (ACS) cases and 55 stable angina pectoris (SAP) cases were studied. By using intravascular ultrasound (IVUS), VV was defined as a small (<1mm) tubular or vesicular, low-echoic structure observed exterior to the media. Prevalence and maximal number of VV were compared between patients with ACS versus SAP.
  
  
  
  The prevalence of VV at the culprit lesion was similar between the 2 groups (97% vs. 93%, p=0.216). On the other hand, it was significantly higher in ACS than SAP at both reference sites (proximal: 93% vs. 81%, p=0.047 and distal: 88% vs. 60%, p<0.001, respectively). The maximum number of VV was significantly higher in ACS than in SAP (at the culprit lesion: 2.8±1.3 vs. 1.8±1.0, p<0.001, at the proximal reference: 1.9±1.1 vs. 1.3±0.9, p=0.003 and distal reference: 1.7±1.1 vs. 1.1±1.1, p=0.003, respectively).
  
  
  
  VV neovascularization of coronary arteries was more enhanced in patients with ACS than in those with SAP, supporting its relation to plaque vulnerability. VV detected by widely used IVUS could be an adequate surrogate marker for plaque vulnerability in vivo.
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan. Electronic address: tteru@med.kawasaki-m.ac.jp.
authors: Teruyoshi
authors: T
authors: Kume
authors: First Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
authors: Hiroyuki
authors: H
authors: Okura
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Ryotaro
authors: R
authors: Yamada
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Terumasa
authors: T
authors: Koyama
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Kenzo
authors: K
authors: Fukuhara
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Yutaka
authors: Y
authors: Goryo
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Yasuhiko
authors: Y
authors: Kamata
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Hiroshi
authors: H
authors: Okamoto
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Tomoko
authors: T
authors: Tamada
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Koichiro
authors: K
authors: Imai
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Yoji
authors: Y
authors: Neishi
authors: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors: Shiro
authors: S
authors: Uemura
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D000368:Aged; D060050:Angina, Stable / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging; D018084:Ultrasonography, Interventional; D014651:Vasa Vasorum / Q000000981:diagnostic imaging*
keywords: Coronary heart disease; Intravascular ultrasound; Plaque vulnerability