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Impact of tissue characteristics on luminal narrowing of mild angiographic coronary stenosis: assessment of integrated backscatter intravascular ultrasound

  • Iwama, Makoto1
  • Tanaka, Shinichiro1, 2, 3
  • Noda, Toshiyuki1
  • Segawa, Tomonori4
  • Kawasaki, Masanori2
  • Nishigaki, Kazuhiko2
  • Minagawa, Taro3
  • Watanabe, Sachiro1
  • Minatoguchi, Shinya2
  • 1 Gifu Prefectural General Medical Center, The Department of Cardiology, Gifu, Japan , Gifu (Japan)
  • 2 Gifu University Graduate School of Medicine, Second Department of Internal Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan , Gifu (Japan)
  • 3 Gifu Cardiovascular Institution, Gifu, Japan , Gifu (Japan)
  • 4 Murakami Memorial Hospital, Asahi University, Department of Cardiovascular Medicine, Gifu, Japan , Gifu (Japan)
Published Article
Heart and Vessels
Publication Date
Oct 24, 2013
DOI: 10.1007/s00380-013-0428-9
Springer Nature


Integrated backscatter intravascular ultrasound (IB-IVUS) is a useful method for analyzing coronary plaque tissue. We evaluated whether tissue composition determined using IB-IVUS is associated with the progression of stenosis in coronary angiography. Sixty-three nontarget coronary lesions in 63 patients with stable angina were evaluated using conventional IVUS and IB-IVUS. IB-IVUS images were analyzed at 1-mm intervals for a length of 10 mm. After calculating the relative areas of the tissue components using the IB-IVUS system, fibrous volume (FV) and lipid volume (LV) were calculated through integration of the slices, after which percentages of per-plaque volume (%FV/PV, %LV/PV) and per-vessel volume (%FV/VV, %LV/VV) were calculated. Progression of coronary stenosis was interpreted from the increase in percent diameter stenosis (%DS) from baseline to the follow-up period (6–9 months) using quantitative coronary angiography. %DS was 24.1 ± 12.8 % at baseline and 23.2 ± 13.7 % at follow-up. Using IB-IVUS, LV was 31.7 ± 10.5 mm3, and %LV/PV and %LV/VV were 45.6 ± 10.3 % and 20.2 ± 6.0 %, respectively. FV, %FV/PV, and %FV/VV were 35.5 ± 12.1 mm3, 52.1 ± 9.5 %, and 23.4 ± 7.1 %, respectively. The change in %DS was −0.88 ± 7.25 % and correlated closely with %LV/VV (r = 0.27, P = 0.03) on simple regression. Multivariate regression after adjustment for potentially confounding risk factors showed %LV/VV to be correlated independently with changes in %DS (r = 0.42, P = 0.02). Logistic regression analysis after adjusting for confounding coronary risk factors showed LV (odds ratio 1.08; 95 % confidence interval 1.01–1.16; P = 0.03) and %LV/VV (odds ratio 1.13; 95 % confidence interval 1.01–1.28; P = 0.03) to be independent predictors of the progression of angiographic coronary stenosis. Our findings suggest that angiographic luminal narrowing of the coronary artery is likely associated with tissue characteristics. IB-IVUS may provide information about the natural progression of luminal narrowing in coronary stenosis.

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