Spectrum of remodeling behavior observed with serial Long-Term (≥12 months) Follow-Up intravascular ultrasound studies in left main coronary arteries

Clemens Von Birgelen* (Corresponding Author), Marc Hartmann, Gary S. Mintz, Dirk Böse, Holger Eggebrecht, Mario Gössl, Till Neumann, Dietrich Baumgart, Heinrich Wieneke, Axel Schmermund, Michael Haude, Raimund Erbel

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    32 Citations (Scopus)

    Abstract

    Most intravascular ultrasound (IVUS) studies of arterial remodeling in native coronary arteries reported a remodeling index obtained at a single time point. We analyzed serial IVUS examinations, including the vessel cross-sectional area changes (remodeling behavior), of 60 hemodynamically nonstenotic left main lesions (baseline vs 18.4 ± 9.4 months follow-up). Lumen reduction resulted from vessel reduction (sometimes despite plaque + media decrease), plaque + media increase (with or without vessel increase), or both. The percent annual changes in lumen area correlated strongly with changes in vessel (r = 0.84), but not with changes in plaque + media area. Plaques were classified as group A lesions, reflecting positive remodeling behavior (vessel changes >0), or group B lesions, reflecting negative (or intermediate) remodeling behavior (vessel changes ≤0). Both groups did not differ significantly in demographics, laboratory data, and medications. Group A lesions (n = 40) more often showed plaque + media increase than group B lesions (32 of 40 [80%] vs 9 of 20 [45%]; p = 0.02). Group A lesions had, on average, mild annual lumen increase despite mild plaque + media increase, i.e, overcompensation of remodeling for plaque + media increase (vessel increase greater than plaque + media area increase, 19 of 40 [47%]). Conversely, group B lesions (n = 20) showed a significant lumen area reduction (-2.8 ± 2.6 mm2/year) as a result of a decrease in vessel area only. Thus, serial long-term reduction of lumen size may result from vessel shrinkage (sometimes despite plaque decrease), plaque increase (with or without vessel increase), or both; overall, only the remodeling behavior has a significant relation to lumen changes. More than 30% of lesions show a negative remodeling behavior, which shows no relation to patient characteristics or initial plaque burden.

    Original languageEnglish
    Pages (from-to)1107-1113
    Number of pages7
    JournalAmerican journal of cardiology
    Volume93
    Issue number9
    DOIs
    Publication statusPublished - 1 May 2004

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