Segmental assessments of coronary plaque morphology and composition by virtual histology intravascular ultrasound and fractional flow reserve

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• 作者：Ju-Hyun Chung ; Soe Hee Ann…
• 关键词：Fractional flow reserve ; Virtual histology intravascular ultrasound ; Plaque composition ; Coronary artery disease ; Segmental analysis
• 刊名：The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：32
• 期：3
• 页码：373-380
• 全文大小：489 KB
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• 作者单位：Ju-Hyun Chung (1)
  Soe Hee Ann (1)
  Gillian Balbir Singh (1)
  Chang-Wook Nam (2)
  Joon-Hyung Doh (3)
  Hyung Il Kim (4)
  Bon-Kwon Koo (5) (6)
  Eun-Seok Shin (1)
  
  1. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
  2. Department of Internal Medicine, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, South Korea
  3. Division of Cardiology, Inje University Ilsan Paik Hospital, Goyang, South Korea
  4. Suntech Research Center, Seoul, South Korea
  5. Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
  6. Institute of Aging, Seoul National University, Seoul, South Korea
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Netherlands
• ISSN：1573-0743

文摘

Fractional flow reserve (FFR) is an index for identifying functionally significant stenotic lesions. A FFR value of ≤0.75 is considered clinically significant and indicative of physiological ischemia. Focal lesions with 30–80 % stenosis by angiography with lesion lengths of less than 20 mm were selected from left anterior descending arteries of 74 patients. The analysis for the total lesion was processed first, and then each lesion was divided into three segments to assess the each segment. Data on plaque geometry and composition of two FFR groups, FFR ≤ 0.75 and FFR > 0.75, were compared by total and segmental analysis. Lesions with FFR ≤ 0.75 had more fibrofatty tissue (13.5 ± 7.4 vs. 10.2 ± 6.5 %, p = 0.05) and less dense calcium (7.2 ± 5.3 vs. 11.9 ± 7.5 %, p = 0.01) compared to lesions with FFR > 0.75. The content of necrotic core in mid segments was higher compared to proximal and distal segments (22.9 ± 10.6, 20.2 ± 10.9, 17.1 ± 11.2 %, respectively, p = 0.032) in lesions with FFR > 0.75 but the difference was less obvious in lesions with FFR ≤ 0.75 (17.9 ± 9.9, 18.7 ± 9.9, 15.8 ± 9.0 %, respectively, p = 0.533). Coronary lesions with FFR > 0.75 have larger content of dense calcium and slightly less fibrofatty tissue compared to lesions with FFR ≤ 0.75. While segmental plaque compositions for each segment show noticeable variations in lesions with FFR > 0.75 such as high concentrations of necrotic core in mid segment, these differences in each segment become obscure in FFR ≤ 0.75 and are evenly distributed across the lesion. Keywords Fractional flow reserve Virtual histology intravascular ultrasound Plaque composition Coronary artery disease Segmental analysis