Archive \ Volume.11 2020 Issue 1

Relation between Coronary Arterial Remodeling and Characteristics of Atherosclerotic Plaque Determined by Intravascular Ultrasound

Sy Van Hoang* , Kha Minh Nguyen , Hung Phi Truong , Luan Tri Mai , Hai Phuong Nguyen Tran
  1. Internal Medicine Department, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
  2. Cardiovascular Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
  3. Interventional Cardiology Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam.

Abstract

Background: Coronary arterial remodeling, which is the change in vessel size due to the presence of atherosclerotic lesions, is associated with plaque characteristics and clinical presentation. However, most studies have included patients with distinct levels of coronary artery stenosis. Objectives: The aim of this study was to assess coronary arterial remodeling and its relationship with the plaque features of coronary atherosclerosis determined by intravascular ultrasound (IVUS) in patients with moderate coronary artery stenosis. Methods: In total, 215 patients with lesions with moderate stenosis underwent UVIS imaging. Measurements included minimal lumen area, total artery area, average reference artery area, plaque area, plaque burden, eccentricity index, and remodeling index (RI). RI>1.0 was defined as positive remodeling and RI≤1.0 as negative remodeling. Results: In total, 88 patients had positive remodeling and 127 had negative remodeling. The two types of remodeling did not differ in terms of patient characteristics and risk factors (p>0.05). The acute coronary syndrome was more common in positive remodeling than in negative remodeling (47.7% vs. 8.7%; OR=9.63; 95%CI: 4.56–20.31; p<0.001). The positive and negative remodeling groups differed significantly in the level of stenosis (43.29±18.80% vs. 50.21±14.31%; p=0.003), plaque area (9.40±3.93 mm2 vs. 7.58±3.29 mm2; p<0.001) and plaque burden (68.95±10.38% vs. 63.76±10.27%; p<0.001), but not in lumen area or eccentricity index (p>0.05). Conclusion: Positive vascular remodeling was more prevalent in acute coronary syndrome than instable angina and had a larger plaque area and a higher plaque burden than negative remodeling. Nevertheless, the stenosis level was still lower with positive remodeling.



How to cite:
Vancouver
Hoang SV, Nguyen KM, Truong HP, Mai LT, Tran HPN. Relation between Coronary Arterial Remodeling and Characteristics of Atherosclerotic Plaque Determined by Intravascular Ultrasound. Arch Pharm Pract. 2020;11(1):54-9.
APA
Hoang, S. V., Nguyen, K. M., Truong, H. P., Mai, L. T., & Tran, H. P. N. (2020). Relation between Coronary Arterial Remodeling and Characteristics of Atherosclerotic Plaque Determined by Intravascular Ultrasound. Archives of Pharmacy Practice, 11(1), 54-59.

Download Citation
References
  1. Zaazaa AM. Celery (Apium graveolens) ethanolic extract ameliorates experimental atherosclerosis in rats. International Journal of Pharmaceutical and Phytopharmacological Research. 2018; 8(4):28-4
  2. National Heart Lung and Blood Institute, Atherosclerosis, [Online]. Available: https://www.nhlbi.nih.gov/health-topics/atherosclerosis. [Accessed: 23rd Dec, 2019].
  3. Linawati NM, Sriwidyani NP, Wande IN, Kamasan A, Wiryawan S, Ratnayanti D, Sugiritama W, Wahyuniari I. The combination extract of pare and apples (APa) reduces risk of atherosclerosis through reduction of interleukin 17 and aggregate focus of liver inflammation in high-fat diet mice. International Journal of Pharmaceutical and Phytopharmacological Research. 2018; 8(4):63-69.
  4. Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N. Engl. J. Med. 1987; 316:1371–1375.
  5. Smits PC, Bos L, Quarles van Ufford MA, Eefting FD, Pasterkamp G, Borst C. Shrinkage of human coronary arteries is an important determinant of de novo atherosclerotic luminal stenosis: an in vivo intravascular ultrasound study. Heart. 1998; 79:143–147.
  6. von Birgelen C, Mintz GS, de Vrey EA, Kimura T, Popma JJ, Airiian SG, Leon MB, Nobuyoshi M, Serruys PW, de Feyter PJ. Atherosclerotic coronary lesions with inadequate compensatory enlargement have smaller plaque and vessel volumes: observations with three dimensional intravascular ultrasound in vivo. Heart. 1998; 79:137–142.
  7. Garcia-Garcia H, Costa M, Serruys P. Imaging of coronary atherosclerosis: Intravascular ultrasound. Eur. Heart J. 2010; 31:2456–2469.
  8. Hartmann M, Huisman J, Böse D, Jensen LO, Schoenhagen P, Mintz GS, Erbel R, von Birgelen C. Serial intravascular ultrasound assessment of changes in coronary atherosclerotic plaque dimensions and composition: an update. Eur. J. Echocardiogr. 2011; 12:313–321.
  9. Ward MR, Jeremias A, Hibi K, Herity N, Lo S, Filardo S, Lee DP, Fitzgerald PJ, Yeung AC. The influence of plaque orientation (pericardial or myocardial) on coronary arterial remodeling. Atherosclerosis. 2001; 154:179–183.
  10. Varnava AM, Mills PG, Davies MJ. Relationship between coronary artery remodeling and plaque vulnerability. Circulation. 2002; 105:939–943.
  11. Gyongyosi M, Yang P, Hassan A, Weidinger F, Domanovits H, Laggner A, Glogar D. Arterial remodelling of native human coronary arteries in patients with unstable angina pectoris: a prospective intravascular ultrasound study. Heart. 1999; 82:68–74.
  12. Jeremias A, Spies C, Herity NA, Pomerantsev E, Yock PG, Fitzgerald PJ, Yeung AC. Coronary artery compliance and adaptive vessel remodelling in patients with stable and unstable coronary artery disease. Heart. 2000; 84:314–319.
  13. Burke AP, Kolodgie FD, Farb A, Weber D, Virmani R. Morphological predictors of arterial remodeling in coronary atherosclerosis. Circulation. 2002; 105:297–303.
  14. Gibbons GH, Dzau VJ. The emerging concept of vascular remodeling. N. Engl. J. Med. 1994; 330:1431–1438.
  15. Tuzcu EM, Kapadia SR, Tutar E, Ziada KM, Hobbs RE, McCarthy PM, Young JB, Nissen SE. High prevalence of coronary atherosclerosis in asymptomatic teenagers and young adults: evidence from intravascular ultrasound. Circulation. 2001; 103:2705–2710.
  16. Schoenhagen P, Ziada KM, Vince DG, Nissen S, Tuscu EM. Arterial remodeling and coronary artery disease: the concept of "dilated" versus "obstructive" coronary atherosclerosis. J. Am. Coll. Cardiol. 2001; 38:297–306.
  17. Ward MR, Pasterkamp G, Yeung AC, Borst C. Arterial remodeling. Mechanisms and clinical implications. Circulation. 2000; 102:1186–1191.
  18. Tauth J, Pinnow E, Sullebarger JT, Basta L, Gursoy S, Lindsay J Jr, Matar F. Predictors of coronary arterial remodeling patterns in patients with myocardial ischemia. Am. J. Cardiol. 1997; 80:1352–1355.
  19. Weissman NJ, Sheris SJ, Chari R, Mendelsohn FO, Anderson WD, Breall JA, Tanguay JF, Diver DJ. Intravascular ultrasonic analysis of plaque characteristics associated with coronary artery remodeling. Am. J. Cardiol. 1999; 84:37–40.
  20. Hamasaki S, Higano ST, Suwaidi JA, Nishimura RA, Miyauchi K, Holmes DR Jr, Lerman A. Cholesterol-lowering treatment is associated with improvement in coronary vascular remodeling and endothelial function in patients with normal or mildly diseased coronary arteries. Arterioscler. Thromb. Vasc. Biol. 2000; 20:737–743.
  21. Ishida S, Hamasaki S, Kamekou M, Yoshitama T, Nakano F, Yoshikawa A, Kataoka T, Saihara K, Minagoe S, Tei C. Advancing age is associated with diminished vascular remodeling and impaired vasodilation in resistance coronary arteries. Coron. Artery. Dis. 2003; 14:443–449.
  22. Hirose M, Kobayashi Y, Mintz GS, Moussa I, Mehran R, Lansky AJ, Dangas G, Kreps EM, Collins MB, Stone GW, Colombo A, Leon MB, Moses JW. Correlation of coronary arterial remodeling determined by intravascular ultrasound with angiographic diameter reduction of 20% to 60%. Am. J. Cardiol. 2003; 92:141–145.
  23. Schoenhagen P, Ziada KM, Kapadia SR, Crowe TD, Nissen SE, Tuzcu EM. Extent and direction of arterial remodeling in stable versus unstable coronary syndromes: an intravascular ultrasound study. Circulation. 2000; 101:598–603.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.