Tissue characterisation of atherosclerotic plaque in the left main: An in vivo intravascular ultrasound radiofrequency data analysis

Nestor Mercado, Tabitha G. Moe, Michael Pieper, John A. House, William J. Dolla, Lindsey Seifert, Joshua M. Stolker, Jason B. Lindsey, Kevin F. Kennedy, Steven P. Marso

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Aims: To characterise plaque phenotypes in the left main stem (LMS) and the proximal left anterior descending (LAD) coronary artery using virtual histology assisted intravascular ultrasound (VH-IVUS). Methods and results: Patients with IVUS pullbacks including no less than the proximal 30 mm of the LAD and through the ostium of the left main were identified from a global IVUS registry. Plaque composition and phenotype frequency in the LMS and five consecutive non-overlapping 6 mm segments in the LAD were studied, resulting in six analysed segments per patient. There were 74 patients (72% male, mean age 65 years). The median LMS length was 5.4 mm (IQR 2.8-8.7 mm). The percent of fibrofatty plaque was greater in the LMS compared to the proximal LAD segments (27.9% [20.0-39.2] vs. 17.3% [12.2-23.1], p<0.001). Dense calcium and necrotic core content was less prevalent in the LMS compared to the LAD segments (2.5% [0.9-4.7] vs. 7.9% [4.1-12.3], p<0.001; and 8.0% [3.7-11.8] vs. 14% [9.2-17.9], p<0.001). The frequency of thin cap fibroatheroma (TCFA) was higher in the LAD compared with LMS (0% vs. 16.9% [4.9- 34.5], p < 0.001,). Within the LAD, TCFA was most frequently observed in the second 6 mm segment, 12 mm from the ostium. Conclusions: TCFA was present more frequently in the proximal LAD than LMS, supporting the notion that plaque rupture occurs in non-uniform locations throughout the coronary tree and preferentially spares the LMS.

Original languageEnglish (US)
Pages (from-to)347-352
Number of pages6
JournalEuroIntervention
Volume7
Issue number3
DOIs
StatePublished - Jul 2011

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Atherosclerotic Plaques
Phenotype
Registries
Rupture
Coronary Vessels
Histology
Calcium

Keywords

  • IVUS
  • Plaque rupture
  • Virtual histology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Tissue characterisation of atherosclerotic plaque in the left main : An in vivo intravascular ultrasound radiofrequency data analysis. / Mercado, Nestor; Moe, Tabitha G.; Pieper, Michael; House, John A.; Dolla, William J.; Seifert, Lindsey; Stolker, Joshua M.; Lindsey, Jason B.; Kennedy, Kevin F.; Marso, Steven P.

In: EuroIntervention, Vol. 7, No. 3, 07.2011, p. 347-352.

Research output: Contribution to journalArticle

Mercado, N, Moe, TG, Pieper, M, House, JA, Dolla, WJ, Seifert, L, Stolker, JM, Lindsey, JB, Kennedy, KF & Marso, SP 2011, 'Tissue characterisation of atherosclerotic plaque in the left main: An in vivo intravascular ultrasound radiofrequency data analysis', EuroIntervention, vol. 7, no. 3, pp. 347-352. https://doi.org/10.4244/EIJV7I3A59
Mercado, Nestor ; Moe, Tabitha G. ; Pieper, Michael ; House, John A. ; Dolla, William J. ; Seifert, Lindsey ; Stolker, Joshua M. ; Lindsey, Jason B. ; Kennedy, Kevin F. ; Marso, Steven P. / Tissue characterisation of atherosclerotic plaque in the left main : An in vivo intravascular ultrasound radiofrequency data analysis. In: EuroIntervention. 2011 ; Vol. 7, No. 3. pp. 347-352.
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abstract = "Aims: To characterise plaque phenotypes in the left main stem (LMS) and the proximal left anterior descending (LAD) coronary artery using virtual histology assisted intravascular ultrasound (VH-IVUS). Methods and results: Patients with IVUS pullbacks including no less than the proximal 30 mm of the LAD and through the ostium of the left main were identified from a global IVUS registry. Plaque composition and phenotype frequency in the LMS and five consecutive non-overlapping 6 mm segments in the LAD were studied, resulting in six analysed segments per patient. There were 74 patients (72{\%} male, mean age 65 years). The median LMS length was 5.4 mm (IQR 2.8-8.7 mm). The percent of fibrofatty plaque was greater in the LMS compared to the proximal LAD segments (27.9{\%} [20.0-39.2] vs. 17.3{\%} [12.2-23.1], p<0.001). Dense calcium and necrotic core content was less prevalent in the LMS compared to the LAD segments (2.5{\%} [0.9-4.7] vs. 7.9{\%} [4.1-12.3], p<0.001; and 8.0{\%} [3.7-11.8] vs. 14{\%} [9.2-17.9], p<0.001). The frequency of thin cap fibroatheroma (TCFA) was higher in the LAD compared with LMS (0{\%} vs. 16.9{\%} [4.9- 34.5], p < 0.001,). Within the LAD, TCFA was most frequently observed in the second 6 mm segment, 12 mm from the ostium. Conclusions: TCFA was present more frequently in the proximal LAD than LMS, supporting the notion that plaque rupture occurs in non-uniform locations throughout the coronary tree and preferentially spares the LMS.",
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T1 - Tissue characterisation of atherosclerotic plaque in the left main

T2 - An in vivo intravascular ultrasound radiofrequency data analysis

AU - Mercado, Nestor

AU - Moe, Tabitha G.

AU - Pieper, Michael

AU - House, John A.

AU - Dolla, William J.

AU - Seifert, Lindsey

AU - Stolker, Joshua M.

AU - Lindsey, Jason B.

AU - Kennedy, Kevin F.

AU - Marso, Steven P.

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N2 - Aims: To characterise plaque phenotypes in the left main stem (LMS) and the proximal left anterior descending (LAD) coronary artery using virtual histology assisted intravascular ultrasound (VH-IVUS). Methods and results: Patients with IVUS pullbacks including no less than the proximal 30 mm of the LAD and through the ostium of the left main were identified from a global IVUS registry. Plaque composition and phenotype frequency in the LMS and five consecutive non-overlapping 6 mm segments in the LAD were studied, resulting in six analysed segments per patient. There were 74 patients (72% male, mean age 65 years). The median LMS length was 5.4 mm (IQR 2.8-8.7 mm). The percent of fibrofatty plaque was greater in the LMS compared to the proximal LAD segments (27.9% [20.0-39.2] vs. 17.3% [12.2-23.1], p<0.001). Dense calcium and necrotic core content was less prevalent in the LMS compared to the LAD segments (2.5% [0.9-4.7] vs. 7.9% [4.1-12.3], p<0.001; and 8.0% [3.7-11.8] vs. 14% [9.2-17.9], p<0.001). The frequency of thin cap fibroatheroma (TCFA) was higher in the LAD compared with LMS (0% vs. 16.9% [4.9- 34.5], p < 0.001,). Within the LAD, TCFA was most frequently observed in the second 6 mm segment, 12 mm from the ostium. Conclusions: TCFA was present more frequently in the proximal LAD than LMS, supporting the notion that plaque rupture occurs in non-uniform locations throughout the coronary tree and preferentially spares the LMS.

AB - Aims: To characterise plaque phenotypes in the left main stem (LMS) and the proximal left anterior descending (LAD) coronary artery using virtual histology assisted intravascular ultrasound (VH-IVUS). Methods and results: Patients with IVUS pullbacks including no less than the proximal 30 mm of the LAD and through the ostium of the left main were identified from a global IVUS registry. Plaque composition and phenotype frequency in the LMS and five consecutive non-overlapping 6 mm segments in the LAD were studied, resulting in six analysed segments per patient. There were 74 patients (72% male, mean age 65 years). The median LMS length was 5.4 mm (IQR 2.8-8.7 mm). The percent of fibrofatty plaque was greater in the LMS compared to the proximal LAD segments (27.9% [20.0-39.2] vs. 17.3% [12.2-23.1], p<0.001). Dense calcium and necrotic core content was less prevalent in the LMS compared to the LAD segments (2.5% [0.9-4.7] vs. 7.9% [4.1-12.3], p<0.001; and 8.0% [3.7-11.8] vs. 14% [9.2-17.9], p<0.001). The frequency of thin cap fibroatheroma (TCFA) was higher in the LAD compared with LMS (0% vs. 16.9% [4.9- 34.5], p < 0.001,). Within the LAD, TCFA was most frequently observed in the second 6 mm segment, 12 mm from the ostium. Conclusions: TCFA was present more frequently in the proximal LAD than LMS, supporting the notion that plaque rupture occurs in non-uniform locations throughout the coronary tree and preferentially spares the LMS.

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KW - Plaque rupture

KW - Virtual histology

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