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European Heart Journal Advance Access originally published online on October 13, 2006
European Heart Journal 2006 27(24):2939-2944; doi:10.1093/eurheartj/ehl285
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Coronary plaque composition of culprit/target lesions according to the clinical presentation: a virtual histology intravascular ultrasound analysis

Jean-François Surmely*, Kenya Nasu, Hiroshi Fujita, Mitsuyasu Terashima, Tetsuo Matsubara, Etsuo Tsuchikane, Mariko Ehara, Yoshihisa Kinoshita, Quan Xiu Zheng, Nobuyoshi Tanaka, Osamu Katoh and Takahiko Suzuki

Department of Cardiology, Toyohashi Heart Center, 21-1, Gobudori, Oyama,Toyohashi, Aichi 441-8530, Japan

Received 12 June 2006; revised 23 August 2006; accepted 14 September 2006; online publish-ahead-of-print 13 October 2006.

* Corresponding author. Tel: +81 532 37 3377; fax: +81 532 37 3366. E-mail address: j-f.surmely{at}heart-center.or.jp

See page 2914 for the editorial comment on this article (doi:10.1093/eurheartj/ehl373)

Aims To evaluate the plaque composition obtained by virtual histology (VH) IVUS according to the clinical presentation and to compare those data to previously published histopathology data.

Methods and results VH was performed on 95 de novo significant lesions (>75% stenosis) in 85 patients [28 acute coronary syndrome (ACS) patients, 30 lesions; 57 stable angina pectoris (SAP) patients, 65 lesions]. There were a higher prevalence of positive remodelling (47 vs. 22%, P=0.013), thrombus (20 vs. 1.5%, P=0.0037), and echo-lucent area (23.3 vs. 7.7%, P=0.047) in ACS patients. At the minimal lumen site, fibrous plaque area was significantly larger in ACS lesions than in SAP lesions (66.0±10.7 vs. 61.4±8.9%, P=0.034), whereas necrotic core and dense calcium plaque area were smaller in ACS lesions (Necrotic core: 6.8±6.0 vs. 11.0±8.3%, P=0.02; Dense calcium: 2.6±3.0 vs. 4.9±5.8%, P=0.03). No differences in rate of thin cap fibroatheroma, thick fibrotheroma, or for the presence of multiple necrotic core layers were observed between both groups.

Conclusion Plaque composition obtained by VH-IVUS shows less necrotic core and more fibrous tissue in ACS compared to SAP lesions, which is in contradiction with previously published histopathologic data.

Key Words: Virtual histology • Atherosclerosis • Imaging • Coronary disease • Histopathology • Acute coronary syndrome


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