Study On The Distribution Characteristics Of Atherosclerosis Plaque In Coronary Artery Segments Clinging To Pericardial Cavity By IVUS

Objective:To investigate the distribution of atherosclerotic plaque in coronary artery segments clinging to pericardial cavity through intravascular ultrasound(IVUS),to explore the factors and mechanisms affecting the eccentric distribution of plaques and provide some theoretical basis for some new methods for the prevention and treatment of atherosclerosis.Methods:A retrospective analysis was performed from January 1,2015 to August 8,2018 in the Department of Cardiology,Zhejiang Hospital.Coronary angiography revealed some narrow main branch of coronary arteries.After receiving informed consent,IVUS was performed.In IVUS images,the images of coronary artery segments clinging to pericardial cavity and had the largest plaque burden were screened out.A total of 50 frames were obtained,corresponding to 50 cases of data.1.To collect baseline clinial data of 50 patients.2.The 50 frames coronary vascular IVUS image is located in clinging to pericardial cavity segment and is recorded as Group ONE.In IVUS images,measure the eccentricity index(EI)of the plaque.The dividing line of the parallel parietal pericardium divides the vessels in the IVUS images into two parts,and the part adjacent to the pericardial cavity is recorded as the pericardial cavity group of the P group(Group ONE),and the part adjacent to the myocardium is recorded as the myocardium group of the M group(Group ONE).The plaque area was measured quantitatively in the two groups,and the difference in plaque area between the two groups was compared.3.In the Group ONE IVUS images,the images of the largest plaque burden were selected in the coronary artery segments non-clinging to pericardial cavity.Satisfy the same vessels as the Group ONE,and located in the anterior descending artery(LAD),set as the Group TWO.Measure the eccentricity index(EI)of the plaques.Refer to the direction of the pericardium in the coronary artery segments clinging to the pericardial cavity,the vessels were divided into two parts by the line was parallel to the parietal pericardium.Refer to the corresponding position in the coronary artery segments clinging to the pericardial cavity,the part adjacent to the pericardial cavity is recorded as the pericardial cavity group of the O group(Group TWO),and the part adjacent to the myocardium is recorded as the myocardium group of the I group(Group TWO).The plaque area was measured quantitatively in the two groups,and the difference in plaque area between the two groups was compared.4.Virtual histology(IVUS-VH)determination of plaque components in the Group ONE and the Group TWO.5.Through coronary CT angiography(CTA),corresponding to the IVUS images of the GROUP ONE or GROUP TWO site,the thickness of epicardial adipose tissue(EAT)in the pericardial side of the vessels(LAD)and the myocardium side of the vessels(LAD)were measured quantitatively.Results:1.Among the 50 patients,76%were male,the average age of patients was(65.56±9.61)years old,70%was unstable angina pectoris,and 66%was hypertension.2.The Group ONE:A total of 34 frames.EI=0.92±0.17,EI>0.5 prompted eccentric plaques.The plaque area in M group was significantly larger than that in P group[(3.36 ± 1.90)mm2 vs(2.00 ± 1.69)mm2,p<0.01].3.The Group TWO:EI=0.94±0.12,EI>0.5 prompted eccentric plaques.The plaque area was no significant difference between the I group and the O group[(2.95± 1.66)mm2 vs(3.25±1.64)mm2,p>0.05].4.The Group ONE(IVUS-VH)proportion of each component:fibrous tissue:(64.09±15.72)%,lipid(8.27±2.97)%,necrotic core(26.18± 15.38)%,dense calcification(1.46± 1.55)%,the Group TWO(IVUS-VH)proportion of each component:fibrous tissue:(62.40±16.13)%,lipid(11.64±6.28)%,necrotic core(24.41 ± 12.66)%,dense calcification(1.54 ± 0.70)%.5.CTA:The EAT of the Group ONE*(EAT)P group side is thinner than M group side[(1.09±0.85)mm vs(3.60±1.66)mm,p<0.01].The EAT of the Group ONE*(EAT)P group side is thinner than the Group TWO(EAT)O group side[(1.09±0.85)mm vs(3.01±1.04)mm,p<0.05].Conclusion:1.Plaque deposit is eccentric with the pericardial cavity surface of the coronary artery intima accumulation less than the myocardial surface of the coronary intima in coronary artery segments clinging to pericardial cavity.2.This eccentric distribution feature can be the result of the combination of intravascular factors-low ESS and extravascular factors-EAT,the comparative study on LAD indicates that EAT can play a major role.3.Treatment of the eccentric plaques in coronary artery segments clinging to pericardial cavity:to prevent and control risk factors,drugs therapy,coronary PCI interventional therapy.