Objective: We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relation between coronary artery remodeling pattern and plaque components in 47 patients.
Methods: We divided the patients into two groups according to the remodeling pattern as positive remodeling (PR, remodeling index>1.05) (n=19) and intermediate remodeling (IR, remodeling index≤1.05 and ≥0.95)/negative remodeling (NR, remodeling indexb0.95) (n=28). VH-IVUS analysis classified the color-coded tissue into four major components: green (fibrotic, FT); yellow–green (fibro-fatty); white (dense calcium); and red (necrotic core, NC). Thin-cap fibro-atheroma (TCFA) was defined as focal, NC-rich (≥10% of the cross-sectional area) plaques being in contact with the lumen in a plaque burden≥40%.
Results: At the minimum lumen site, PR group had greater plaque plus media area (12.3±4.1vs. 10.8±4.1mm2, p<0.001) and greater %NC area (30.1±12.3 vs. 26.2±11.6%, p<0.001) and smaller %FT area (59.0±14.5 vs. 51.4±14.6%, p=0.037) compared with IR/NR group. PR group had greater greater %NC volume (18.3±9.6 vs. 15.4±9.2%, p=0.001) and smaller %FT volume (59.6±11.7 vs. 52.9±11.0%, p=0.009) compared with IR/NR group.
Conclusions: VH-IVUS analysis demonstrates that PR was associated with more vulnerable plaque components compared with IR/NR regardless of their clinical presentation.
Keywords: coronary plaque, plaque components, intravascular ultrasound, positive remodeling.