Relationship Between Arterial and Fibrous Cap Remodeling

Yamada, Ryotaro; Okura, Hiroyuki; Kume, Teruyoshi; Saito, Ken; Miyamoto, Yoshinori; Imai, Kyoichi; Tsuchiya, Tetsuo; Maehama, Tomoko; Okahashi, Nobuyuki; Obase, Kikuko; Hayashida, Akihiro; Neishi, Yoji; Kawamoto, Takahiro; Yoshida, Kiyoshi

doi:10.1161/circinterventions.109.928911

Cited by 34 publications

(4 citation statements)

References 45 publications

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“…The mechanism that induces arterial remodeling in diabetes is likely to be complex. Positive remodeling is commonly associated with vulnerable plaque characterized by greater plaque volume, necrotic core [ 31 ] and thinning change of the fibrous cap [ 32 ]. In diabetic patients, advanced plaque phenotype and further atherosclerosis progression could still be found despite lipid-lowering therapy [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Increased glycated albumin and decreased esRAGE levels in serum are related to negative coronary artery remodeling in patients with type 2 diabetes: an Intravascular ultrasound study

Zhang

Lü

et al. 2018

Cardiovasc Diabetol

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BackgroundNegative coronary artery remodeling is frequent in patients with diabetes, but its mechanism remains unclear. We here evaluated the association of serum levels of glycated albumin (GA) and endogenous secretory receptor for advanced glycation end products (esRAGE) with coronary artery remodeling in type 2 diabetic patients.MethodsSerum levels of GA and esRAGE were measured and intravascular ultrasound was performed in 136 consecutive diabetic patients with 143 coronary intermediate lesions. The remodeling index (RI) was calculated as the ratio between external elastic membrane (EEM) area at the lesion site and EEM area at the reference segment. Negative remodeling (NR) was defined as an RI < 0.95 and intermediate or positive remodeling as an RI ≥ 0.95.ResultsMean plaque burden at the lesion site was 70.96 ± 9.98%, and RI was 0.96 ± 0.18. Negative coronary arterial remodeling existed in 81 (56.6%) lesions. RI correlated closely with serum esRAGE level (r = 0.236, P = 0.005) and was inversely related to serum GA level (r = − 0.240, P = 0.004) and plasma low-density lipoprotein cholesterol (LDL-C) (r = − 0.206, P = 0.014) and total cholesterol levels (r = − 0.183, P = 0.028). Generalized estimating equations logistic regression analysis identified esRAGE (OR 0.037; 95% CI 0.012–0.564, P = 0.021), GA (OR 1.093; 95% CI 1.013–1.179, P = 0.018) and LDL-C (OR 1.479; 95% CI 1.072–2.835, P = 0.023) as independent predictors for negative remodeling.ConclusionsIn diabetic patients, negative coronary artery remodeling is associated with increased GA and decreased esRAGE levels in serum.

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Section: Discussionmentioning

confidence: 99%

Increased glycated albumin and decreased esRAGE levels in serum are related to negative coronary artery remodeling in patients with type 2 diabetes: an Intravascular ultrasound study

Zhang

Lü

et al. 2018

Cardiovasc Diabetol

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“…Therefore, large plaque burden with increased vessel diameter (PR) determined by IVUS study would be a significant risk factor for rupture of coronary plaques. A recent study of serial IVUS and optical coherence tomography (OCT) showed that positive arterial remodeling was related to thinning change of the fibrous cap [22]. Therefore, it is clear that PR is associated with vulnerable plaque and progression of atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Association of insulin resistance and coronary artery remodeling: an intravascular ultrasound study

Kim

Moon

Lim

et al. 2015

Cardiovasc Diabetol

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BackgroundThere are few studies that investigated the correlation between insulin resistance (IR) and the coronary artery remodeling. The aim of the study is to investigate the association of IR measured by homeostasis model assessment of insulin resistance (HOMA-IR) and coronary artery remodeling evaluated by intravascular ultrasound (IVUS).MethodsA total of 298 consecutive patients who received percutaneous coronary interventions under IVUS guidance were retrospectively enrolled. The value of HOMA-IR more than 2.5 was considered as IR positive. Metabolic syndrome was classified according to NCEP ATP III guidelines. The remodeling index was defined as the ratio of the external elastic membrane (EEM) area at the lesion site to the EEM area at the proximal reference site.ResultsA total of 369 lesions were analyzed (161 lesions in HOMA-IR positive and 208 lesions in HOMA-IR negative). Remodeling index was significantly higher in the HOMA-IR positive group compared with the negative group (HOMA-IR positive vs. negative: 1.074 ± 0.109 vs. 1.042 ± 0.131, p = 0.013). There was a significant positive correlation between remodeling index and HOMA-IR (p = 0.010). Analysis of HOMA-IR according to remodeling groups showed increasing tendency of HOMA-IR, and it was statistically significant (p = 0.045). Multivariate analysis revealed that only HOMA-IR was an independent predictor of remodeling index (r = 0.166, p = 0.018).ConclusionIncreased IR estimated by HOMA-IR was significantly associated with a higher remodeling index and positive coronary artery remodeling.

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“…Rupture can occur when an increased macrophage concentration accumulates at the shoulders of the affected plaque and starts releasing metalloproteinases, thus creating a weak point and potential thrombus release [17, 18]. Another factor that has also been linked with vulnerable plaque is remodelling, which involve physical changes to TCFAs [19] such as intraplaque neovascularisation [16]. …”

Section: Detection Of Thin-cap Fibroatheromamentioning

confidence: 99%

Research and Clinical Applications of Optical Coherence Tomography in Invasive Cardiology: A Review

Vignali¹,

Solinas²,

Emanuele³

2014

CCR

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In cardiology, optical coherence tomography (OCT) is an invasive imaging technique based on the principle of light coherence. This system was developed to obtain three-dimensional high resolution images to examine coronary artery normal and/or pathological structure. This technique replaces the ultrasound used by its main alternative procedure, intravascular ultrasound, by a near-infrared light source. Acute coronary syndromes due to atherosclerotic vascular disease are the leading cause of mortality in developed and developing countries. As a consequence, intravascular imaging systems became an important area of research and 1991 marks the first use of OCT in coronary artery observations. Since its first appearance in invasive cardiology, OCT maintains a strong presence in the research environments for the identification of vulnerable plaques, as it is able to overcome difficulties presented by other techniques such as virtual intravascular ultrasound, near-infrared spectroscopy, and histology. Moreover, OCT is increasingly being used in the clinical practice as a guide during coronary interventions and in the assessment of vascular response after coronary stent implantation. This review focuses on the relevance of OCT in research and clinical applications in the field of invasive cardiology and discusses the future directions of the field.

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Relationship Between Arterial and Fibrous Cap Remodeling

Cited by 34 publications

References 45 publications

Increased glycated albumin and decreased esRAGE levels in serum are related to negative coronary artery remodeling in patients with type 2 diabetes: an Intravascular ultrasound study

Increased glycated albumin and decreased esRAGE levels in serum are related to negative coronary artery remodeling in patients with type 2 diabetes: an Intravascular ultrasound study

Association of insulin resistance and coronary artery remodeling: an intravascular ultrasound study

Research and Clinical Applications of Optical Coherence Tomography in Invasive Cardiology: A Review

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