Size of emptied plaque cavity following spontaneous rupture is related to coronary dimensions, not to the degree of lumen narrowing. A study with intravascular ultrasound in vivo

Heart. 2000 Nov;84(5):483-8. doi: 10.1136/heart.84.5.483.

Abstract

Objective: To identify any potential relations between the size of an emptied plaque cavity and the remodelling pattern, plaque or vessel dimensions, lumen narrowing, and other ultrasonic lesion characteristics.

Design: Intravascular ultrasound was used to examine prospectively 51 ruptured ulcerated coronary plaques. Cross sectional area measurements comprised lumen, vessel, plaque, and emptied plaque cavity. Lumen narrowing was calculated as 1 - (lesion lumen area/reference lumen area) x 100%. A remodelling index was calculated as lesion vessel area/reference vessel area, and plaques were divided into those with values > 1.05 (group A) and </= 1.05 (group B).

Results: Of the total of 51 plaques, 36 (71%) were assigned to group A and 15 (29%) to group B. In neither group was there a significant difference in reference dimensions and lumen narrowing. However, lesion vessel (mean (SD): 22.6 (8.1) mm(2) v 17. 5 (4.3) mm(2); p = 0.006) and plaque areas (15.8 (6.2) mm(2) v 12.8 (3.2) mm(2); p = 0.03) were greater in group A than in group B. The cavity inside the plaque was larger in group A than in group B (2.8 (1.6) mm(2) v 1.8 (0.9) mm(2); p = 0.007) and showed a positive linear relation with lesion and reference vessel size (r = 0.58 and 0.56, respectively; p < 0.001), but not with lumen narrowing.

Conclusions: The size of the emptied cavity inside ruptured plaques is on average larger in lesions with adaptive vascular remodelling, and shows a linear relation with lesion plaque and vessel size and with the reference dimensions, but not with the degree of lumen narrowing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / pathology
  • Dilatation, Pathologic / diagnostic imaging
  • Dilatation, Pathologic / pathology
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Rupture, Spontaneous / diagnostic imaging
  • Rupture, Spontaneous / pathology
  • Ultrasonography, Interventional