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.

译文

背向散射积分血管内超声 (ib-ivus) 是分析冠状动脉斑块组织的有用方法。我们评估了使用ib-ivus确定的组织成分是否与冠状动脉造影的狭窄进展相关。使用常规IVUS和ib-ivus评估了63例稳定型心绞痛患者的63例非目标冠状动脉病变。以1mm的间隔分析ib-ivus图像的长度为10毫米。使用ib-ivus系统计算组织成分的相对面积后,通过切片的积分计算纤维体积 (FV) 和脂质体积 (LV),之后每斑块体积的百分比 (% FV/PV,% LV/PV) 和每个容器体积 (% FV/VV,% LV/VV) 进行计算。使用定量冠状动脉造影从基线到随访期 (6-9个月) 的直径狭窄百分比 (% DS) 的增加来解释冠状动脉狭窄的进展。% DS在基线时为24.1 ± 12.8%,在随访时为23.2 ± 13.7%。使用ib-ivus,LV为31.7 ± 10.5立方毫米,% LV/PV和 % LV/VV分别为45.6 ± 10.3% 和20.2 ± 6.0%。FV、 % FV/PV和 % FV/VV分别为35.5 ± 12.1立方毫米、52.1 ± 9.5% 和23.4 ± 7.1%。% DS的变化为-0.88 ± 7.25%,并且在简单回归时与 % LV/VV密切相关 (r = 0.27,P = 0.03)。对潜在混杂危险因素进行校正后的多元回归显示 % LV/VV与 % DS的变化独立相关 (r = 0.42,P = 0.02)。校正混杂冠状动脉危险因素后的Logistic回归分析显示LV (优势比1.08; 95% 置信区间1.01-1.16; P = 0.03) 和 % LV/VV (优势比1.13; 95% 置信区间1.01-1.28; P = 0.03) 是血管造影冠状动脉狭窄进展的独立预测因子。我们的发现表明,冠状动脉的血管造影管腔狭窄可能与组织特征有关。Ib-ivus可能提供有关冠状动脉狭窄管腔变窄的自然进展的信息。

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