- 作者：Kenichi Tsujita ; Kenji Sakamoto ; Sunao Kojima ; Shinobu Kojima ; Naoko Takaoka ; Yasuhiro Nagayoshi ; Tomohiro Sakamoto ; Shinji Tayama ; Koichi Kaikita ; Seiji Hokimoto ; Hitoshi Sumida ; Seigo Sugiyama ; Sunao Nakamura ; Hisao Ogawa
- 关键词：Vasospasm ; Ultrasonics ; Plaque ; Tissue ; Imaging
- 刊名：International Journal of Cardiology
- 出版年：2013
- 出版时间：3 October, 2013
- 年：2013
- 卷：168
- 期：3
- 页码：2411-2415
- 全文大小：454 K
Background
Coronary spasm plays an important role in the pathogenesis of ischemic heart disease. However, tissue components of coronary plaque in patients with vasospastic angina (VSA) have been unknown. This study used virtual histology (VH)-intravascular ultrasound (IVUS) to elucidate the tissue component of spastic coronary arteries and its gender differences in patients with VSA.Methods
According to acetylcholine provocation tests, the study subjects (42 patients [19 men, 23 women, 61 ¡À 13 years]) were divided into 2 groups: the VSA group of 26 patients and the non-VSA group of 16 patients. After nitrate injection, IVUS volumetric analysis was done, and the parameters were compared between the groups.
Results
Although clinical demographics were almost identical between the groups, VSA group had lower plasma adiponectin level (5.9 ¡À 3.3 ¦Ìg/ml vs. 11.2 ¡À 7.6 ¦Ìg/ml, p = 0.007) and tended to have higher high-sensitivity C-reactive protein (0.15 ¡À 0.24 mg/dl vs. 0.06 ¡À 0.04 mg/dl, p = 0.1) than non-VSA group. VSA group had diffusely thickened intima ( % plaque volume, 34 ¡À 11 % vs. 27 ¡À 7 % , p = 0.01) compared with non-VSA group. However, plaque components of patients with VSA were similar with that of non-VSA patients (dense calcium, 4 ¡À 6 % vs. 3 ¡À 4 % ; necrotic core, 10 ¡À 9 % vs. 8 ¡À 6 % ; fibrofatty, 19 ¡À 16 % vs. 22 ¡À 11 % ; and fibrous, 67 ¡À 16 % vs. 67 ¡À 9 % ). Although male patients with VSA had atherogenic lipid and metabolic profiles than female VSA patients, there were no significant gender differences in the volumetric IVUS parameters and plaque components.
Conclusions
Compared with non-VSA patients, VSA patients had diffusely thickened fibrous-dominant coronary plaque without gender difference, and that might suggest the role of vasospasm in the development of atherosclerosis.