Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 5-6, Pages: 308-314
https://doi.org/10.2298/SARH1306308I
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Virtual histology study of atherosclerotic plaque composition in patients with stable angina and acute phase of acute coronary syndromes without ST segment elevation
Ivanović Miloš (Medicinski fakultet, Kragujevac)
Rančić Milan (Srpsko lekarsko društvo, Beograd)
Rdzanek Adam (Department of Cardiology, Central University Hospital, Medical University of Warsaw, Warsaw, Poland)
Filipjak Krzysztof J. (Department of Cardiology, Central University Hospital, Medical University of Warsaw, Warsaw, Poland)
Opolski Grzegorz (Department of Cardiology, Central University Hospital, Medical University of Warsaw, Warsaw, Poland)
Cvetanović Jelena (Medicinski fakultet, Kragujevac)
Introduction. Rupture of vulnerable atherosclerotic plaques is the cause of
most acute coronary syndromes (ACS). Postmortem studies which compared stable
coronary lesions and atherosclerotic plaques in patients who have died
because of ACS indicated high lipid-core content as one of the major
determinants of plaque vulnerability. Objective. Our primary goal was to
assess the potential relations of plaque composition determined by IVUS-VH
(Intravascular Ultrasound - Virtual Histology) in patients with stable angina
and subjects in acute phase of ACS without ST segment elevation. Methods. The
study comprised of 40 patients who underwent preintervention IVUS
examination. Tissue maps were reconstructed from radio frequency data using
IVUS-VH software. Results. We analyzed 53 lesions in 40 patients. Stable
angina was diagnosed in 24 patients (29 lesions), while acute phase of ACS
without ST elevation was diagnosed in 16 patients (24 lesions). In the
patients in acute phase of ACS without ST segment elevation IVUS-VH
examination showed a significantly larger area of the necrotic core at the
site of minimal lumen area and a larger mean of the necrotic core volume in
the entire lesion comparing to stable angina subjects (1.84±0.90 mm2 vs.
0.96±0.69 mm2; p<0.001 and 20.94±15.79 mm3 vs. 11.54±14.15 mm3; p<0.05
respectively). Conclusion. IVUS-VH detected that the necrotic core was
significantly larger in atherosclerotic lesions in patients in acute phase of
ACS without ST elevation comparing to the stable angina subjects and that it
could be considered as a marker of plaque vulnerability.
Keywords: atherosclerotic plaque, virtual histology, intravascular ultrasound, acute coronary syndrome, stable angina