BACKGROUND: Imaging of coronary plaques has traditionally focused on evaluating degree of stenosis, as the risk for adverse cardiac events increases with stenosis severity. However, the relation between plaque composition and severity of stenosis remains largely unknown. OBJECTIVE: To assess plaque composition (non-invasively by multislice computed tomography (MSCT) angiography and invasively by virtual histology intravascular ultrasound (VH IVUS)) in relation to degree of stenosis. METHODS: 78 patients underwent MSCT (identifying three plaque types; non-calcified, calcified, mixed) followed by invasive coronary angiography and VH IVUS. VH IVUS evaluated plaque burden, minimal lumen area and plaque composition (fibrotic, fibro-fatty, necrotic core, dense calcium) and plaques were classified as fibrocalcific, fibroatheroma, thin-capped fibroatheroma (TCFA), pathological intimal thickening. For each plaque, percentage stenosis was evaluated by quantitative coronary angiography. Significant stenosis was defined >50% stenosis. RESULTS: Overall, 43 plaques (19%) corresponded to significant stenosis. Of the 227 plaques analysed, 70 were non-calcified plaques (31%), 96 mixed (42%) and 61 calcified (27%) on MSCT. Plaque types on MSCT were equally distributed among significant and non-significant stenoses. VH IVUS identified that plaques with significant stenosis had higher plaque burden (67% (11%) vs 53% (12%), p<0.05) and smaller minimal lumen area (4.6 (3.8-6.8) mm(2) vs 7.3 (5.4-10.5) mm(2), p<0.05). Interestingly, no differences were observed in percentage fibrotic, fibro-fatty, necrotic core and dense calcium. Non-significant stenoses were more frequently classified as pathological intimal thickening (46 (25%) vs 3 (7%), p<0.05), although TCFA (more vulnerable plaque) was distributed equally (p = 0.18). CONCLUSION: No evident association exists between the degree of stenosis and plaque composition or vulnerability, as evaluated non-invasively by MSCT and invasively by VH IVUS.
BACKGROUND: Imaging of coronary plaques has traditionally focused on evaluating degree of stenosis, as the risk for adverse cardiac events increases with stenosis severity. However, the relation between plaque composition and severity of stenosis remains largely unknown. OBJECTIVE: To assess plaque composition (non-invasively by multislice computed tomography (MSCT) angiography and invasively by virtual histology intravascular ultrasound (VH IVUS)) in relation to degree of stenosis. METHODS: 78 patients underwent MSCT (identifying three plaque types; non-calcified, calcified, mixed) followed by invasive coronary angiography and VH IVUS. VH IVUS evaluated plaque burden, minimal lumen area and plaque composition (fibrotic, fibro-fatty, necrotic core, dense calcium) and plaques were classified as fibrocalcific, fibroatheroma, thin-capped fibroatheroma (TCFA), pathological intimal thickening. For each plaque, percentage stenosis was evaluated by quantitative coronary angiography. Significant stenosis was defined >50% stenosis. RESULTS: Overall, 43 plaques (19%) corresponded to significant stenosis. Of the 227 plaques analysed, 70 were non-calcified plaques (31%), 96 mixed (42%) and 61 calcified (27%) on MSCT. Plaque types on MSCT were equally distributed among significant and non-significant stenoses. VH IVUS identified that plaques with significant stenosis had higher plaque burden (67% (11%) vs 53% (12%), p<0.05) and smaller minimal lumen area (4.6 (3.8-6.8) mm(2) vs 7.3 (5.4-10.5) mm(2), p<0.05). Interestingly, no differences were observed in percentage fibrotic, fibro-fatty, necrotic core and dense calcium. Non-significant stenoses were more frequently classified as pathological intimal thickening (46 (25%) vs 3 (7%), p<0.05), although TCFA (more vulnerable plaque) was distributed equally (p = 0.18). CONCLUSION: No evident association exists between the degree of stenosis and plaque composition or vulnerability, as evaluated non-invasively by MSCT and invasively by VH IVUS.
Authors: Michiel A de Graaf; Joella E van Velzen; Fleur R de Graaf; Joanne D Schuijf; Jouke Dijkstra; Jeroen J Bax; Johan H C Reiber; Martin J Schalij; Ernst E van der Wall; J Wouter Jukema Journal: Heart Vessels Date: 2012-02-18 Impact factor: 2.037
Authors: Rodrigo Cerci; Andrea L Vavere; Julie M Miller; Kihei Yoneyama; Carlos E Rochitte; Marc Dewey; Hiroyuki Niinuma; Melvin E Clouse; Roger Laham; David E Bush; Edward P Shapiro; Albert C Lardo; Christopher Cox; Jeffrey Brinker; Joăo A C Lima; Armin Arbab-Zadeh Journal: Int J Cardiovasc Imaging Date: 2013-05-24 Impact factor: 2.357
Authors: J E van Velzen; M A de Graaf; A Ciarka; F R de Graaf; M J Schalij; L J Kroft; A de Roos; J W Jukema; J H C Reiber; J D Schuijf; J J Bax; E E van der Wall Journal: Int J Cardiovasc Imaging Date: 2012-01-24 Impact factor: 2.357
Authors: Guillermo Sánchez-Elvira; Isabel Coma-Canella; Miguel Artaiz; José Antonio Páramo; Joaquín Barba; José Calabuig Journal: Heart Int Date: 2010-12-31
Authors: Joëlla E van Velzen; Fleur R de Graaf; Michiel A de Graaf; Joanne D Schuijf; Lucia J Kroft; Albert de Roos; Johan H C Reiber; Jeroen J Bax; J Wouter Jukema; Eric Boersma; Martin J Schalij; Ernst E van der Wall Journal: J Nucl Cardiol Date: 2011-07-19 Impact factor: 5.952
Authors: E E van der Wall; F R de Graaf; J E van Velzen; J W Jukema; J J Bax; J D Schuijf Journal: Int J Cardiovasc Imaging Date: 2010-07-11 Impact factor: 2.357
Authors: Wijnand J Stuijfzand; Pieter G Raijmakers; Roel S Driessen; Niels van Royen; Alexander Nap; Albert C van Rossum; Paul Knaapen Journal: Curr Cardiovasc Imaging Rep Date: 2015