| Objective: To discuss the potential relationship of plaque burden and coronary remodeling in acute coronary syndrome(ACS)patients.Methods: Ninety-one patients with ACS in Qingdao Municipal Hospital during 2011 January to 2014 June were inspected by the conventional coronary angiography and intravascular ultrasound(IVUS)examination.60 cases were positive remodeling[Remodeling index(RI)>1],and 31 cases were negative remodeling(RI?1).In 91 patients,there were 9 cases(PB<60%),19 cases(60%?PB<70%),48 cases(70%?PB<80%),15 cases(PB380%).The difference of plaque cross-sectional area(P-CSA),lumen cross-sectional area(L-CSA),external elastic membrane cross-sectional area(EEM-CSA),average EEM-CSA,PB between positive remodeling and negative remodeling were compared by independent-samples T test.Adopting ANOVA evaluate the difference of P-CSA,L-CSA,EEM-CSA,RI among different PB.The relevance of PB,P-CSA,EEM-CSA,L-CSA,RI were analyzed by Pearson correlation analysis.Results: There were no significant differences in P-CSA,L-CSA,EEM-CSA,PB between positive remodeling and negative remodeling.Average EEM-CSA of negative remodeling were significantly greater than positive remodeling [(13.24±1.98)mm2 vs(17.30±3.16)mm2,t=2.46,P<0.05].P-CSA,EEM-CSA and L-CSA had significant differences(F=24.56,28.97,7.14,P<0.001)while RI had not statistical significance among different PB.With the increase of PB,P-CSA and EEM-CSA were increased[P-CSA:(6.01±1.68),(9.12±2.00),(11.42±2.05),(14.05±4.00)mm2,EEM-CSA:(11.43±1.90),(13.64±2.93),(15.14±2.64),(16.64±4.08)mm2],L-CSA was reduced[(5.44±0.89),(4.52±0.99),(3.72±0.74),(2.60±0.63)mm2].RI was not linked to PB(r=-0.05,P=0.67).Conclusions: Coronary artery remodeling is a very complicated dynamic process.Except the PB,there are propably other factors to affect the direction of remodeling.And RI may be sub-optimal as the criteria for the assessment of vascular remodeling.Objective: To discuss the relationship of plaque burden,lumen size,external elastic membrane size and remodeling by analyzing the coronary computed tomography angiography parameters of patients with coronary heart disease.Methods: Seventy-six patients with CHD in Qingdao Municipal Hospital during 2010 January to 2015 June were inspected by the coronary computed tomography angiographyexamination existed left main coronary artery or proximal left anterior descending disease.44 cases were positive remodeling(RI31.05),11 cases were negative remodeling(RI?0.95),and 21 cases were no remodeling(0.95<RI<1.05).In 76 patients,there were 15 cases[20%?Plaque burden(PB)<40%],32 cases(40%?PB<60%),27 cases(60%?PB<80%),2 cases(PB380%).The difference of plaque burden,proximal and distal external elastic membrane diameter,lesion lumen diameter,lesion external elastic membrane diameter among positive remodeling,negative remodeling and no remodeling were compared with single factor analysis of variance.Using the above method to comared RI,plaque burden,proximal and distal external elastic membrane diameter,lesion lumen diameter,lesion external elastic membrane diameter among different PB.Results: There were no significant differences in plaque burden among positive remodeling negative remodeling and no remodeling while lesionand proximal external elastic membrane diameterhad significant differences.Differences of lesion lumen diameter and lesion external elastic membrane diameterwere statistical significance among different PB.RI,proximal and distal external elastic membrane diameterhad not statistical significance among different PB.RI was not linked to PB(r=-0.195,P=0.092).Conclusions: Coronary artery plaque and external elastic membraneaffect the size of the lumen and interact on each other.Applicating CCTA to judge the types of remodeling of coronary artery lesions in diagnosis,prevention and treatment of coronary heart disease is of important value. |
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