Document Detail


What has intravascular ultrasound taught us about plaque biology?
MedLine Citation:
PMID:  11286648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intravascular ultrasound (IVUS) has a defined role in the cardiac catheterization laboratory to assess lesion severity and the procedural success of vascular interventions. However, IVUS has also contributed to our understanding of the biology of atherosclerosis and restenosis. In acute coronary syndromes, IVUS has revealed varying degrees of stenosis, thrombosis, and plaque derangement typical of the plaque disruption seen in many pathologic studies of patients who have died of this condition. IVUS has demonstrated that the culprit lesions of patients surviving acute coronary syndromes also tend to be softer, with less calcium, and tend to have more plaque with positive arterial remodeling (compensatory enlargement) than lesions causing stable coronary syndromes. Arterial remodeling is also an important component of restenosis after coronary interventions. IVUS has suggested that interventions that reduce restenosis tend to have a greater impact on preventing negative remodeling (constriction) rather than reducing neointimal proliferation. Oxidant stress may be an important contributor to negative remodeling, as IVUS has demonstrated this anatomy at sites of coronary artery spasm. Positive remodeling seen by IVUS is also associated with impaired endothelial vasomotor dysfunction, and IVUS studies have demonstrated the contribution of vasomotor tone to arterial elasticity. Future directions include integrating IVUS with other imaging modalities, such as angiography, to study the interaction of anatomic and physiologic factors in atherosclerosis progression, and using the raw ultrasound signal to distinguish plaque components and differences in wall strain that may identify vulnerable plaques.
Authors:
S Kinlay
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current atherosclerosis reports     Volume:  3     ISSN:  1523-3804     ISO Abbreviation:  Curr Atheroscler Rep     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-04-05     Completed Date:  2001-07-19     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100897685     Medline TA:  Curr Atheroscler Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  260-6     Citation Subset:  IM    
Affiliation:
Intravascular Ultrasound, Cardiac Catheterization Laboratory, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. skinlay@rics.bwh.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Arteriosclerosis / ultrasonography
Graft Occlusion, Vascular / ultrasonography
Humans
Ultrasonography, Interventional*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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