Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations: An in-vivo optical coherence tomography study

Haibo Jia, Sining Hu, Shiro Uemura, Seung Jung Park, Yangsoo Jang, Abhiram Prasad, Stephen Lee, Tsunenari Soeda, Farhad Abtahian, Rocco Vergallo, Jinwei Tian, Hang Lee, Peter H. Stone, Bo Yu, Ik Kyung Jang

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVES: The aim of this study was to investigate the spatial location of vulnerable plaques at coronary artery bifurcations using frequency domain-optical coherence tomography. BACKGROUND: In-vivo data on geometric location of vulnerable plaques in relation to coronary bifurcation are limited. MATERIALS AND METHODS: A total of 40 patients with left anterior descending artery bifurcation were studied. Plaque characteristics in five regions in relation to a side branch were compared: opposite flow divider (OFD); bifurcation site (BF); main branch side proximal (MBP); side branch side proximal (SBP); and flow divider (FD). Frequency domain-optical coherence tomography was used for plaque characterization. RESULTS: Seventy-two lipid-rich plaques and 15 thin-cap fibroatheroma (TCFA) were detected in 220 regions of 44 bifurcations. Overall, the main branch side had more vulnerable characteristics compared with the side branch side. The FD was rarely affected by lipid accumulation. The OFD showed the highest prevalence of lipid-rich plaques [47.7% (OFD) vs. 45.5% (MBP), 43.2% (BF), 18.2% (SBP), and 9.1% (FD), P<0.0001] and TCFA [20.5% (OFD) vs. 6.8% (MBP), 6.8% (BF), 2.2% (SBP), and 0.0% (FD), P<0.001] and the thinnest fibrous cap [88.7±43.7μm (OFD) vs. 123.5±62.7μm (MBP), 149.6±77.0μm (BF), 157.4±65.4μm (SBP), and 163.6±76.9μm (FD), P=0.002] compared with other regions. CONCLUSION: Lipid accumulation tends to develop in the zone opposite the side branch. TCFA was localized predominantly in the region OFD, whereas FD was rarely affected.

Original languageEnglish (US)
Pages (from-to)133-141
Number of pages9
JournalCoronary Artery Disease
Volume26
Issue number2
DOIs
StatePublished - Mar 13 2015
Externally publishedYes

Fingerprint

Optical Coherence Tomography
Coronary Vessels
Atherosclerotic Plaques
Lipids
Arteries

Keywords

  • bifurcation
  • distribution
  • optical coherence tomography
  • vulnerable plaque

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations : An in-vivo optical coherence tomography study. / Jia, Haibo; Hu, Sining; Uemura, Shiro; Park, Seung Jung; Jang, Yangsoo; Prasad, Abhiram; Lee, Stephen; Soeda, Tsunenari; Abtahian, Farhad; Vergallo, Rocco; Tian, Jinwei; Lee, Hang; Stone, Peter H.; Yu, Bo; Jang, Ik Kyung.

In: Coronary Artery Disease, Vol. 26, No. 2, 13.03.2015, p. 133-141.

Research output: Contribution to journalArticle

Jia, H, Hu, S, Uemura, S, Park, SJ, Jang, Y, Prasad, A, Lee, S, Soeda, T, Abtahian, F, Vergallo, R, Tian, J, Lee, H, Stone, PH, Yu, B & Jang, IK 2015, 'Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations: An in-vivo optical coherence tomography study', Coronary Artery Disease, vol. 26, no. 2, pp. 133-141. https://doi.org/10.1097/MCA.0000000000000188
Jia, Haibo ; Hu, Sining ; Uemura, Shiro ; Park, Seung Jung ; Jang, Yangsoo ; Prasad, Abhiram ; Lee, Stephen ; Soeda, Tsunenari ; Abtahian, Farhad ; Vergallo, Rocco ; Tian, Jinwei ; Lee, Hang ; Stone, Peter H. ; Yu, Bo ; Jang, Ik Kyung. / Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations : An in-vivo optical coherence tomography study. In: Coronary Artery Disease. 2015 ; Vol. 26, No. 2. pp. 133-141.
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abstract = "OBJECTIVES: The aim of this study was to investigate the spatial location of vulnerable plaques at coronary artery bifurcations using frequency domain-optical coherence tomography. BACKGROUND: In-vivo data on geometric location of vulnerable plaques in relation to coronary bifurcation are limited. MATERIALS AND METHODS: A total of 40 patients with left anterior descending artery bifurcation were studied. Plaque characteristics in five regions in relation to a side branch were compared: opposite flow divider (OFD); bifurcation site (BF); main branch side proximal (MBP); side branch side proximal (SBP); and flow divider (FD). Frequency domain-optical coherence tomography was used for plaque characterization. RESULTS: Seventy-two lipid-rich plaques and 15 thin-cap fibroatheroma (TCFA) were detected in 220 regions of 44 bifurcations. Overall, the main branch side had more vulnerable characteristics compared with the side branch side. The FD was rarely affected by lipid accumulation. The OFD showed the highest prevalence of lipid-rich plaques [47.7{\%} (OFD) vs. 45.5{\%} (MBP), 43.2{\%} (BF), 18.2{\%} (SBP), and 9.1{\%} (FD), P<0.0001] and TCFA [20.5{\%} (OFD) vs. 6.8{\%} (MBP), 6.8{\%} (BF), 2.2{\%} (SBP), and 0.0{\%} (FD), P<0.001] and the thinnest fibrous cap [88.7±43.7μm (OFD) vs. 123.5±62.7μm (MBP), 149.6±77.0μm (BF), 157.4±65.4μm (SBP), and 163.6±76.9μm (FD), P=0.002] compared with other regions. CONCLUSION: Lipid accumulation tends to develop in the zone opposite the side branch. TCFA was localized predominantly in the region OFD, whereas FD was rarely affected.",
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T1 - Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations

T2 - An in-vivo optical coherence tomography study

AU - Jia, Haibo

AU - Hu, Sining

AU - Uemura, Shiro

AU - Park, Seung Jung

AU - Jang, Yangsoo

AU - Prasad, Abhiram

AU - Lee, Stephen

AU - Soeda, Tsunenari

AU - Abtahian, Farhad

AU - Vergallo, Rocco

AU - Tian, Jinwei

AU - Lee, Hang

AU - Stone, Peter H.

AU - Yu, Bo

AU - Jang, Ik Kyung

PY - 2015/3/13

Y1 - 2015/3/13

N2 - OBJECTIVES: The aim of this study was to investigate the spatial location of vulnerable plaques at coronary artery bifurcations using frequency domain-optical coherence tomography. BACKGROUND: In-vivo data on geometric location of vulnerable plaques in relation to coronary bifurcation are limited. MATERIALS AND METHODS: A total of 40 patients with left anterior descending artery bifurcation were studied. Plaque characteristics in five regions in relation to a side branch were compared: opposite flow divider (OFD); bifurcation site (BF); main branch side proximal (MBP); side branch side proximal (SBP); and flow divider (FD). Frequency domain-optical coherence tomography was used for plaque characterization. RESULTS: Seventy-two lipid-rich plaques and 15 thin-cap fibroatheroma (TCFA) were detected in 220 regions of 44 bifurcations. Overall, the main branch side had more vulnerable characteristics compared with the side branch side. The FD was rarely affected by lipid accumulation. The OFD showed the highest prevalence of lipid-rich plaques [47.7% (OFD) vs. 45.5% (MBP), 43.2% (BF), 18.2% (SBP), and 9.1% (FD), P<0.0001] and TCFA [20.5% (OFD) vs. 6.8% (MBP), 6.8% (BF), 2.2% (SBP), and 0.0% (FD), P<0.001] and the thinnest fibrous cap [88.7±43.7μm (OFD) vs. 123.5±62.7μm (MBP), 149.6±77.0μm (BF), 157.4±65.4μm (SBP), and 163.6±76.9μm (FD), P=0.002] compared with other regions. CONCLUSION: Lipid accumulation tends to develop in the zone opposite the side branch. TCFA was localized predominantly in the region OFD, whereas FD was rarely affected.

AB - OBJECTIVES: The aim of this study was to investigate the spatial location of vulnerable plaques at coronary artery bifurcations using frequency domain-optical coherence tomography. BACKGROUND: In-vivo data on geometric location of vulnerable plaques in relation to coronary bifurcation are limited. MATERIALS AND METHODS: A total of 40 patients with left anterior descending artery bifurcation were studied. Plaque characteristics in five regions in relation to a side branch were compared: opposite flow divider (OFD); bifurcation site (BF); main branch side proximal (MBP); side branch side proximal (SBP); and flow divider (FD). Frequency domain-optical coherence tomography was used for plaque characterization. RESULTS: Seventy-two lipid-rich plaques and 15 thin-cap fibroatheroma (TCFA) were detected in 220 regions of 44 bifurcations. Overall, the main branch side had more vulnerable characteristics compared with the side branch side. The FD was rarely affected by lipid accumulation. The OFD showed the highest prevalence of lipid-rich plaques [47.7% (OFD) vs. 45.5% (MBP), 43.2% (BF), 18.2% (SBP), and 9.1% (FD), P<0.0001] and TCFA [20.5% (OFD) vs. 6.8% (MBP), 6.8% (BF), 2.2% (SBP), and 0.0% (FD), P<0.001] and the thinnest fibrous cap [88.7±43.7μm (OFD) vs. 123.5±62.7μm (MBP), 149.6±77.0μm (BF), 157.4±65.4μm (SBP), and 163.6±76.9μm (FD), P=0.002] compared with other regions. CONCLUSION: Lipid accumulation tends to develop in the zone opposite the side branch. TCFA was localized predominantly in the region OFD, whereas FD was rarely affected.

KW - bifurcation

KW - distribution

KW - optical coherence tomography

KW - vulnerable plaque

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