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Impact of tissue characteristics on luminal narrowing of mild angiographic coronary stenosis: assessment of integrated backscatter intravascular ultrasound

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Abstract

Integrated backscatter intravascular ultrasound (IB-IVUS) is a useful method for analyzing coronary plaque tissue. We evaluated whether tissue composition determined using IB-IVUS is associated with the progression of stenosis in coronary angiography. Sixty-three nontarget coronary lesions in 63 patients with stable angina were evaluated using conventional IVUS and IB-IVUS. IB-IVUS images were analyzed at 1-mm intervals for a length of 10 mm. After calculating the relative areas of the tissue components using the IB-IVUS system, fibrous volume (FV) and lipid volume (LV) were calculated through integration of the slices, after which percentages of per-plaque volume (%FV/PV, %LV/PV) and per-vessel volume (%FV/VV, %LV/VV) were calculated. Progression of coronary stenosis was interpreted from the increase in percent diameter stenosis (%DS) from baseline to the follow-up period (6–9 months) using quantitative coronary angiography. %DS was 24.1 ± 12.8 % at baseline and 23.2 ± 13.7 % at follow-up. Using IB-IVUS, LV was 31.7 ± 10.5 mm3, and %LV/PV and %LV/VV were 45.6 ± 10.3 % and 20.2 ± 6.0 %, respectively. FV, %FV/PV, and %FV/VV were 35.5 ± 12.1 mm3, 52.1 ± 9.5 %, and 23.4 ± 7.1 %, respectively. The change in %DS was −0.88 ± 7.25 % and correlated closely with %LV/VV (r = 0.27, P = 0.03) on simple regression. Multivariate regression after adjustment for potentially confounding risk factors showed %LV/VV to be correlated independently with changes in %DS (r = 0.42, P = 0.02). Logistic regression analysis after adjusting for confounding coronary risk factors showed LV (odds ratio 1.08; 95 % confidence interval 1.01–1.16; P = 0.03) and %LV/VV (odds ratio 1.13; 95 % confidence interval 1.01–1.28; P = 0.03) to be independent predictors of the progression of angiographic coronary stenosis. Our findings suggest that angiographic luminal narrowing of the coronary artery is likely associated with tissue characteristics. IB-IVUS may provide information about the natural progression of luminal narrowing in coronary stenosis.

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Acknowledgments

Hirotaka Miwa MD, Shingo Minatoguchi MD, Fumitaka Tokoro MD, Reiko Matsuoka MD, Shintaro Abe MD, Yoshiaki Goto MD, Shunnichiro Warita MD, Tai Kojima MD, Takeshi Hirose MD, Koji Ono MD, and Shintaro Tanihata, MD participated in data collection for this study. We would like to thank Mr Kaoru Kawasaki and Mr Yoshiaki Kodera for maintaining the experimental equipment.

Conflict of interest

The authors of this article have no conflicts of interest, and no relation with industry.

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Authors and Affiliations

  1. The Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan

    Makoto Iwama, Shinichiro Tanaka, Toshiyuki Noda & Sachiro Watanabe

  2. Second Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan

    Shinichiro Tanaka, Masanori Kawasaki, Kazuhiko Nishigaki & Shinya Minatoguchi

  3. Gifu Cardiovascular Institution, Gifu, Japan

    Shinichiro Tanaka & Taro Minagawa

  4. Department of Cardiovascular Medicine, Murakami Memorial Hospital, Asahi University, Gifu, Japan

    Tomonori Segawa

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  1. Makoto Iwama
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  2. Shinichiro Tanaka
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  3. Toshiyuki Noda
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  4. Tomonori Segawa
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  5. Masanori Kawasaki
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  7. Taro Minagawa
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  9. Shinya Minatoguchi
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Corresponding author

Correspondence to Shinya Minatoguchi.

Additional information

M. Iwama and S. Tanaka contributed equally to this work.

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Iwama, M., Tanaka, S., Noda, T. et al. Impact of tissue characteristics on luminal narrowing of mild angiographic coronary stenosis: assessment of integrated backscatter intravascular ultrasound. Heart Vessels 29, 750–760 (2014). https://doi.org/10.1007/s00380-013-0428-9

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