| Target lesion thin-cap fibroatheroma defined by virtual histology intravascular ultrasound affects microvascular injury during percutaneous coronary intervention in patients with angina pectoris. | |
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MedLine Citation:
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PMID: 20595776 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Several reports suggest that virtual histology intravascular ultrasound (VH-IVUS) assessment could predict microvascular damage during percutaneous coronary intervention (PCI). A novel index of microcirculatory resistance (IMR) has been developed as a reproducible and less hemodynamic-dependent index. The purpose of this study was to investigate the relationship between thin-cap fibroatheroma (TCFA) defined by VH-IVUS and a change in the IMR during PCI in patients with angina pectoris (AP). METHODS AND RESULTS: The study investigated 30 lesions from 28 AP patients. VH-IVUS imaging was performed before PCI. TCFA was defined as the presence of confluent necrotic core (>10%) without detectable overlying fibrous cap segment. Patients were divided into 2 groups according to the presence of TCFA. Using a pressure guidewire, IMR were measured before and after PCI. After successful PCI, patients were prospectively followed up clinically. TCFA was detected in 9 lesions (30%). IMR tended to improve after PCI in the non-TCFA group, but tended to worsen in the TCFA group. DeltaIMR (=IMR after PCI-IMR before PCI) was significantly higher in the TCFA group compared with the non-TCFA group (13.2+/-29.9 vs -4.4+/-16.0, P=0.04). During follow-up (mean 20 months), survival free of major adverse cardiac events was significantly less in the TCFA group than in the non-TCFA group. CONCLUSIONS: Target lesion TCFA may be related to both microvascular injury and the long-term clinical outcome after successful PCI in patients with AP. |
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Authors:
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Ryotaro Yamada; Hiroyuki Okura; Teruyoshi Kume; Yoji Neishi; Takahiro Kawamoto; Yoshinori Miyamoto; Koichiro Imai; Ken Saito; Tetsuo Tsuchiya; Akihiro Hayashida; Kiyoshi Yoshida |
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Publication Detail:
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Type: Journal Article Date: 2010-06-29 |
Journal Detail:
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Title: Circulation journal : official journal of the Japanese Circulation Society Volume: 74 ISSN: 1347-4820 ISO Abbreviation: Circ. J. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-30 Completed Date: 2010-12-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: Japan |
Other Details:
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Languages: eng Pagination: 1658-62 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Kawasaki Medical School, Kurashiki, Japan. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angina Pectoris / therapy* Angioplasty, Balloon, Coronary / adverse effects* Female Humans Male Microvessels / injuries* Middle Aged Plaque, Atherosclerotic / complications*, diagnosis, ultrasonography* Treatment Outcome Ultrasonography, Interventional Vascular Resistance* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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