OBJECTIVE: This study aimed to evaluate the relationship between the occurrence of the angiographic no-reflow phenomenon in patients with acute myocardial infarction (AMI) and the preintervention plaque composition as assessed by virtual histology intravascular ultrasound (VH-IVUS). BACKGROUND: The angiographic no-reflow phenomenon is an adverse prognostic factor in patients with AMI. METHOD: We enrolled consecutive 50 patients with ST-elevation AMI was treated by primary stent implantation. All culprit lesions were imaged by VH-IVUS before stent implantation. The angiographic no-reflow phenomenon was defined as a decrease in final TIMI flow grade compared with TIMI flow grade before stent implantation. RESULTS: Eight of 50 patients developed angiographic no-reflow after stent implantation. Gray-scale intravascular ultrasound (IVUS) showed significantly larger external elastic membrane volume and plaque burden in the no-reflow group. VH-IVUS showed a trend toward larger percentage of fibro-fatty plaque volume in the no-reflow group than in the reflow group (23.1 +/- 3.5 vs. 17.0 +/- 1.1%, P = 0.05). The presence of "marble"-like image, mainly consisting of fibro-fatty and fibrous plaque (plaque volume of fibro-fatty + fibrous >80% and containing fibro-fatty plaque volume >10%) was associated with angiographic no-reflow (P = 0.02). Corrected TIMI frame counts of the cases with "marble"-like image were significantly larger than the cases without it (46.8 +/- 5.6 vs. 27.4 +/- 2.3, P = 0.01). CONCLUSION: The culprit lesions with large plaque burden, or with "marble"-like image by VH-IVUS, are associated with the angiographic no-reflow phenomenon in patients with AMI.
OBJECTIVE: This study aimed to evaluate the relationship between the occurrence of the angiographic no-reflow phenomenon in patients with acute myocardial infarction (AMI) and the preintervention plaque composition as assessed by virtual histology intravascular ultrasound (VH-IVUS). BACKGROUND: The angiographic no-reflow phenomenon is an adverse prognostic factor in patients with AMI. METHOD: We enrolled consecutive 50 patients with ST-elevation AMI was treated by primary stent implantation. All culprit lesions were imaged by VH-IVUS before stent implantation. The angiographic no-reflow phenomenon was defined as a decrease in final TIMI flow grade compared with TIMI flow grade before stent implantation. RESULTS: Eight of 50 patients developed angiographic no-reflow after stent implantation. Gray-scale intravascular ultrasound (IVUS) showed significantly larger external elastic membrane volume and plaque burden in the no-reflow group. VH-IVUS showed a trend toward larger percentage of fibro-fatty plaque volume in the no-reflow group than in the reflow group (23.1 +/- 3.5 vs. 17.0 +/- 1.1%, P = 0.05). The presence of "marble"-like image, mainly consisting of fibro-fatty and fibrous plaque (plaque volume of fibro-fatty + fibrous >80% and containing fibro-fatty plaque volume >10%) was associated with angiographic no-reflow (P = 0.02). Corrected TIMI frame counts of the cases with "marble"-like image were significantly larger than the cases without it (46.8 +/- 5.6 vs. 27.4 +/- 2.3, P = 0.01). CONCLUSION: The culprit lesions with large plaque burden, or with "marble"-like image by VH-IVUS, are associated with the angiographic no-reflow phenomenon in patients with AMI.
Authors: Jennifer Huisman; Rasmus Egede; Adam Rdzanek; Dirk Böse; Raimund Erbel; Janusz Kochman; Lisette Okkels Jensen; Job van der Palen; Marc Hartmann; Gary S Mintz; Clemens von Birgelen Journal: Int J Cardiovasc Imaging Date: 2012-01-14 Impact factor: 2.357
Authors: Wan Ho Kim; Hyun Woong Park; Ki Hong Kim; In Girl Song; Dong Ju Yang; Chung Seop Lee; Young Hoon Seo; Taek Geun Kwon; Jang-Ho Bae Journal: Korean Circ J Date: 2012-01-31 Impact factor: 3.243
Authors: Jennifer Huisman; Marc Hartmann; Gary S Mintz; Gert K van Houwelingen; Martin G Stoel; Frits H A F de Man; Hans W Louwerenburg; Clemens von Birgelen Journal: Int J Cardiovasc Imaging Date: 2011-03-19 Impact factor: 2.357
Authors: Ki Hong Kim; Wan Ho Kim; Hyun Woong Park; In Girl Song; Dong Ju Yang; Young Hoon Seo; Hyung Bin Yuk; Yo Han Park; Taek Geun Kwon; Charanjit S Rihal; Amir Lerman; Moo-Sik Lee; Jang-Ho Bae Journal: Korean Circ J Date: 2013-06-30 Impact factor: 3.243
Authors: Young Joon Hong; Myung Ho Jeong; Yun Ha Choi; Jum Suk Ko; Min Goo Lee; Won Yu Kang; Shin Eun Lee; Soo Hyun Kim; Keun Ho Park; Doo Sun Sim; Nam Sik Yoon; Hyun Ju Youn; Kye Hun Kim; Hyung Wook Park; Ju Han Kim; Youngkeun Ahn; Jeong Gwan Cho; Jong Chun Park; Jung Chaee Kang Journal: Eur Heart J Date: 2009-02-19 Impact factor: 29.983