관상동맥 경화반 구성 요소의 용적 전형적인 심혈관 위험 요인과 대사 증후군과의 관계
The Relationship Between Volumetric Plaque Components and Classical Cardiovascular Risk Factors and the Metabolic
- 주제(키워드) virtual histology intravascular ultrasound , cardiovascular risk factors , coronary artery disease , imaging , plaque vulnerability
- 발행기관 아주대학교
- 지도교수 탁승제
- 발행년도 2011
- 학위수여년월 2011. 8
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000011901
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Objectives: The aim of this study was to analyze volumetric plaque composition of the coronary arterial tree according to the classical cardiovascular risk factors and metabolic syndrome (MS) by using virtual histology-intravascular ultrasound (VH-IVUS). Background: It remains unclear how the cardiovascular risk factors correlate with the histological components of coronary plaques. Methods: “Whole vessel” VH-IVUS analysis was performed in 189 vessels of 63 patients. The components of atherosclerotic plaques were classified as fibrous, fibrofatty, necrotic core (NC), and dense calcium. Quantitative assessment of these plaque components and the presence of VH-IVUS-derived thin-cap fibroatheroma (VH-TCFA) in the coronary arterial trees were compared to cardiovascular risk factors. Results: There was a significantly larger mean plaque+media (P+M) burden in patients with diabetes mellitus (DM) (47±5 vs. 39±7% in non-DM patients, p<0.001) and MS (47±4 vs. 39±7% in non-MS patients, p<0.001). DM patients had a significantly larger %NC (17.8±5.6 vs. 12.5±6.1, p=0.003) compared to non-DM patients; and MS patients had a significantly larger %NC (17.3±5.8 vs. 12.8±6.2, p=0.016) as compared to non-MS patients. Finally, VH-TCFAs were more frequent in DM patients (3.4±2.0 vs. 2.1±1.7 in non-DM patients, p=0.016) and in MS patients (4.1±2.1 vs. 1.9±1.4 in non-MS patients, p=0.001). Conclusions: Three-vessel VH-IVUS analysis showed that DM and MS patients had a larger P+M burden, larger amount of NC, and more frequent VH-TCFAs in coronary arterial trees compared to patients without DM or MS implying greater plaque vulnerability in DM and MS patients.
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ABSTRACT ⅰ
TABLE OF CONTENTS ⅲ
LIST OF FIGURES ⅴ
LIST OF TABLES ⅵ
ABBREVIATIONS ⅶ
I. INTRODUCTION 1
II. MATERIALS AND METHODS 3
A. MATERIALS 3
1. Study population 3
2. Definition of the risk factors 3
B. METHODS 4
3. IVUS imaging and analysis 4
4. Statistical analysis 6
III. RESULTS 8
A. The baseline clinical and VH-IVUS characteristics 8
B. IVUS and VH-IVUS findings according to the classical risk factors and the metabolic risk factors associated to metabolic syndrome 11
C. Multivariate analysis of the risk factors for the plaque burden, the %NC and the VH-TCFAs 20
IV. DISCUSSION 22
V. STUDY LIMITATION 27
VI. CONCLUTION 29
REFERENCES 30
국문요약 36
LIST OF FIGURES
Fig. 1. VH-TCFAs in regard to being with or without risk factors 19
Fig. 2. The correlation between the plaque components and the metabolic syndrome
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