Intravascular ultrasound assessment of patterns of arterial remodeling in the absence of significant reference segment plaque burden in patients with coronary artery disease

Myeong Ki Hong, Gary S. Mintz, Cheol Whan Lee, Young Hak Kim, Jae Whan Lee, Jong Min Song, Ki Hoon Han, Duk Hyun Kang, Jae Kwan Song, Jae Joong Kim, Seong Wook Park, Seung Jung Park

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Abstract

OBJECTIVES: We evaluated the impact of reference vessel segment plaque burden on lesion remodeling. BACKGROUND: Intravascular ultrasound (IVUS) assessment of lesion remodeling compares lesions to reference segments. However, reference segments are rarely disease-free and, therefore, have also undergone remodeling changes. METHODS: Pre-intervention IVUS was obtained in 274 patients with right coronary artery lesions selected because the right coronary artery has less tapering and fewer side branches than the left anterior descending or left circumflex artery. Standard IVUS definitions were used. Patients were divided according to reference vessel segment plaque burden: group A (minimal reference disease, n = 91), both proximal and distal reference plaque burden <20%; group B (n = 91), either proximal or distal reference plaque burden 20% to 40% but both ≤40%; and group C (n = 92), either proximal or distal reference plaque burden >40%. RESULTS: The remodeling index measured 0.98 ± 0.16 in group A (range, 0.68 to 1.47), 1.04 ± 0.15 in group B (range, 0.67 to 1.91), and 1.04 ± 0.15 in group C (range, 0.74 to 1.70), analysis of variance p = 0.0208 (p = 0.0234 group A vs. group B and p = 0.0012 group A vs. group C, but p = 0.8 group B vs. group C). Positive, intermediate, and negative remodeling were observed in 24 (26%), 24 (26%), and 43 lesions (48%) in group A; 36 (40%), 28 (30%), and 27 lesions (30%) in group B; and 34 (37%), 39 (42%), and 19 lesions (21%) in group C, respectively (p = 0.0022). CONCLUSIONS: Negative remodeling occurs commonly in coronary lesions with minimal reference segment disease. Negative remodeling is not just an "artifact" introduced by comparing lesions to diseased reference segments.

Original languageEnglish
Pages (from-to)806-810
Number of pages5
JournalJournal of the American College of Cardiology
Volume42
Issue number5
DOIs
Publication statusPublished - 2003 Sep 3

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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