Pericardial distribution of atherosclerotic plaques in the left anterior descending artery was associated with positive vessel remodelling in 89% of lesions (P<0.001).
Cross-Sectional (n=70)
Does the transversal distribution of coronary atherosclerotic plaques (pericardial vs myocardial) affect vessel remodelling in the left anterior descending artery?
Atherosclerotic plaques with a pericardial distribution in the left anterior descending artery are strongly associated with positive vessel remodelling, suggesting a permissive role of epicardial fat.
p-value: p=<0.001
AIMS: The transversal distribution of coronary atherosclerotic plaques (AP) (myocardial vs pericardial) affects vessel remodelling. The aim of this study was to define the impact of transversal lesion distribution on vessel remodelling in proximal and distal coronary segments using a 3D intravascular ultrasound (IVUS) reconstruction. METHODS: The study group included 70 lesions located in the left anterior descending artery within 5mm of the septal take-off, and imaged using 3D-IVUS. The take-off of the septal branch was used to divide the plaque into a myocardial and pericardial surface. The IVUS index of vessel remodelling was calculated as: narrowest external elastic membrane (EEM) site cross-sectional area (CSA)-reference EEM CSA)/reference EEM CSAx100. The lesions with an intermediate vessel remodelling index (between -25% and +15%) were excluded from analysis. RESULTS: Of the 38 APs with a pericardial distribution, 34 (89%) showed positive remodelling (P<0.001). The distal lesions had a positive vessel remodelling index regardless of transversal plaque distribution. At multivariate analysis, pericardial distribution and the distal location of AP were the only independent variables predictive of positive remodelling. CONCLUSIONS: The transversal distribution of atherosclerotic plaque affects vessel remodelling in left anterior descending coronary lesions, probably because of an extravascular splinting effect. Distal lesions usually show positive remodelling regardless of transversal plaque distribution.
Francesco Prati (Sat,) conducted a cross-sectional in Coronary atherosclerotic plaques (n=70). Pericardial distribution of atherosclerotic plaques vs. Myocardial distribution of atherosclerotic plaques was evaluated on Positive vessel remodelling (p=<0.001). Pericardial distribution of atherosclerotic plaques in the left anterior descending artery was associated with positive vessel remodelling in 89% of lesions (P<0.001).