Plaque distribution and vascular remodeling of ruptured and nonruptured coronary plaques in the same vessel: An intravascular ultrasound study in vivo

Clemens Von Birgelen, Wolfgang Klinkhart, Gary S. Mintz, Alexandra Papatheodorou, Joerg Herrmann, Dietrich Baumgart, Michael Haude, Heinrich Wieneke, Junbo Ge, Raimund Erbel

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: This study was designed to identify potential differences between the intravascular ultrasound (IVUS) characteristics of spontaneously ruptured and nonruptured coronary plaques. BACKGROUND: The identification of vulnerable plaques in vivo may allow targeted prevention of acute coronary events and more effective evaluation of novel therapeutic approaches. METHODS: Intravascular ultrasound was used to identify 29 ruptured plaques in arteries containing another nonruptured plaque in an adjacent segment. Intravascular ultrasound characteristics of these plaques were compared with plaques of computer-matched controls without evidence of plaque rupture. Plaque distribution was assessed by measuring the eccentricity of lumen location (inside the total vessel). Lumen cross-sectional area narrowing was calculated as [1 -(target/reference lumen area)] × 100%. A remodeling index was calculated as lesion/reference arterial area (>1.05 = compensatory enlargement, <0.95 = shrinkage). RESULTS: Among the three groups of plaques, there was no significant difference in quantitative angiographic parameters, IVUS reference dimensions and IVUS lumen cross-sectional area narrowing. There was a difference in plaque distribution; lumen location by IVUS was significantly more eccentric in ruptured than in nonruptured (p = 0.002) and control plaques (p < 0.0001). The arc of disease-free vessel wall was larger in ruptured than in control plaques (p < 0.0001). The remodeling pattern of ruptured and nonruptured plaques differed significantly from that of the control plaques (p = 0.0001 and 0.003); compensatory enlargement was found in 66%, 48%, and 17%, whereas shrinkage was found in 7%, 10% and 48%, respectively. CONCLUSIONS: Intravascular ultrasound assessment of plaque distribution and vascular remodeling may help to classify plaques with the highest probability of spontaneous rupture.

Original languageEnglish (US)
Pages (from-to)1864-1870
Number of pages7
JournalJournal of the American College of Cardiology
Volume37
Issue number7
DOIs
StatePublished - Jun 1 2001
Externally publishedYes

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Spontaneous Rupture
Rupture
Arteries
Therapeutics
Vascular Remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Plaque distribution and vascular remodeling of ruptured and nonruptured coronary plaques in the same vessel : An intravascular ultrasound study in vivo. / Von Birgelen, Clemens; Klinkhart, Wolfgang; Mintz, Gary S.; Papatheodorou, Alexandra; Herrmann, Joerg; Baumgart, Dietrich; Haude, Michael; Wieneke, Heinrich; Ge, Junbo; Erbel, Raimund.

In: Journal of the American College of Cardiology, Vol. 37, No. 7, 01.06.2001, p. 1864-1870.

Research output: Contribution to journalArticle

Von Birgelen, Clemens ; Klinkhart, Wolfgang ; Mintz, Gary S. ; Papatheodorou, Alexandra ; Herrmann, Joerg ; Baumgart, Dietrich ; Haude, Michael ; Wieneke, Heinrich ; Ge, Junbo ; Erbel, Raimund. / Plaque distribution and vascular remodeling of ruptured and nonruptured coronary plaques in the same vessel : An intravascular ultrasound study in vivo. In: Journal of the American College of Cardiology. 2001 ; Vol. 37, No. 7. pp. 1864-1870.
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abstract = "OBJECTIVES: This study was designed to identify potential differences between the intravascular ultrasound (IVUS) characteristics of spontaneously ruptured and nonruptured coronary plaques. BACKGROUND: The identification of vulnerable plaques in vivo may allow targeted prevention of acute coronary events and more effective evaluation of novel therapeutic approaches. METHODS: Intravascular ultrasound was used to identify 29 ruptured plaques in arteries containing another nonruptured plaque in an adjacent segment. Intravascular ultrasound characteristics of these plaques were compared with plaques of computer-matched controls without evidence of plaque rupture. Plaque distribution was assessed by measuring the eccentricity of lumen location (inside the total vessel). Lumen cross-sectional area narrowing was calculated as [1 -(target/reference lumen area)] × 100{\%}. A remodeling index was calculated as lesion/reference arterial area (>1.05 = compensatory enlargement, <0.95 = shrinkage). RESULTS: Among the three groups of plaques, there was no significant difference in quantitative angiographic parameters, IVUS reference dimensions and IVUS lumen cross-sectional area narrowing. There was a difference in plaque distribution; lumen location by IVUS was significantly more eccentric in ruptured than in nonruptured (p = 0.002) and control plaques (p < 0.0001). The arc of disease-free vessel wall was larger in ruptured than in control plaques (p < 0.0001). The remodeling pattern of ruptured and nonruptured plaques differed significantly from that of the control plaques (p = 0.0001 and 0.003); compensatory enlargement was found in 66{\%}, 48{\%}, and 17{\%}, whereas shrinkage was found in 7{\%}, 10{\%} and 48{\%}, respectively. CONCLUSIONS: Intravascular ultrasound assessment of plaque distribution and vascular remodeling may help to classify plaques with the highest probability of spontaneous rupture.",
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T1 - Plaque distribution and vascular remodeling of ruptured and nonruptured coronary plaques in the same vessel

T2 - An intravascular ultrasound study in vivo

AU - Von Birgelen, Clemens

AU - Klinkhart, Wolfgang

AU - Mintz, Gary S.

AU - Papatheodorou, Alexandra

AU - Herrmann, Joerg

AU - Baumgart, Dietrich

AU - Haude, Michael

AU - Wieneke, Heinrich

AU - Ge, Junbo

AU - Erbel, Raimund

PY - 2001/6/1

Y1 - 2001/6/1

N2 - OBJECTIVES: This study was designed to identify potential differences between the intravascular ultrasound (IVUS) characteristics of spontaneously ruptured and nonruptured coronary plaques. BACKGROUND: The identification of vulnerable plaques in vivo may allow targeted prevention of acute coronary events and more effective evaluation of novel therapeutic approaches. METHODS: Intravascular ultrasound was used to identify 29 ruptured plaques in arteries containing another nonruptured plaque in an adjacent segment. Intravascular ultrasound characteristics of these plaques were compared with plaques of computer-matched controls without evidence of plaque rupture. Plaque distribution was assessed by measuring the eccentricity of lumen location (inside the total vessel). Lumen cross-sectional area narrowing was calculated as [1 -(target/reference lumen area)] × 100%. A remodeling index was calculated as lesion/reference arterial area (>1.05 = compensatory enlargement, <0.95 = shrinkage). RESULTS: Among the three groups of plaques, there was no significant difference in quantitative angiographic parameters, IVUS reference dimensions and IVUS lumen cross-sectional area narrowing. There was a difference in plaque distribution; lumen location by IVUS was significantly more eccentric in ruptured than in nonruptured (p = 0.002) and control plaques (p < 0.0001). The arc of disease-free vessel wall was larger in ruptured than in control plaques (p < 0.0001). The remodeling pattern of ruptured and nonruptured plaques differed significantly from that of the control plaques (p = 0.0001 and 0.003); compensatory enlargement was found in 66%, 48%, and 17%, whereas shrinkage was found in 7%, 10% and 48%, respectively. CONCLUSIONS: Intravascular ultrasound assessment of plaque distribution and vascular remodeling may help to classify plaques with the highest probability of spontaneous rupture.

AB - OBJECTIVES: This study was designed to identify potential differences between the intravascular ultrasound (IVUS) characteristics of spontaneously ruptured and nonruptured coronary plaques. BACKGROUND: The identification of vulnerable plaques in vivo may allow targeted prevention of acute coronary events and more effective evaluation of novel therapeutic approaches. METHODS: Intravascular ultrasound was used to identify 29 ruptured plaques in arteries containing another nonruptured plaque in an adjacent segment. Intravascular ultrasound characteristics of these plaques were compared with plaques of computer-matched controls without evidence of plaque rupture. Plaque distribution was assessed by measuring the eccentricity of lumen location (inside the total vessel). Lumen cross-sectional area narrowing was calculated as [1 -(target/reference lumen area)] × 100%. A remodeling index was calculated as lesion/reference arterial area (>1.05 = compensatory enlargement, <0.95 = shrinkage). RESULTS: Among the three groups of plaques, there was no significant difference in quantitative angiographic parameters, IVUS reference dimensions and IVUS lumen cross-sectional area narrowing. There was a difference in plaque distribution; lumen location by IVUS was significantly more eccentric in ruptured than in nonruptured (p = 0.002) and control plaques (p < 0.0001). The arc of disease-free vessel wall was larger in ruptured than in control plaques (p < 0.0001). The remodeling pattern of ruptured and nonruptured plaques differed significantly from that of the control plaques (p = 0.0001 and 0.003); compensatory enlargement was found in 66%, 48%, and 17%, whereas shrinkage was found in 7%, 10% and 48%, respectively. CONCLUSIONS: Intravascular ultrasound assessment of plaque distribution and vascular remodeling may help to classify plaques with the highest probability of spontaneous rupture.

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