Related Experiment Video
Updated: Sep 20, 2026
Intravascular Ultrasound Image-Based Finite Element Modeling Approach for Quantifying In Vivo Mechanical Properties of Human Coronary Artery
Published on: December 6, 2024
Coronary arterial remodeling in differing clinical presentations of unstable angina pectoris--an intravascular
Takahiro Iwami1, Toshihiko Nishioka, Michael C Fishbein
1Division of Cardiology, Tokuyama Central Hospital, Tokuyama, Japan.
Insights
Positive coronary arterial remodeling is more common in patients experiencing new-onset angina pectoris. This finding suggests that coronary artery remodeling patterns may influence how ischemic heart disease presents clinically.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Imaging
Background:
- Coronary arterial remodeling significantly impacts ischemic heart disease presentation.
- Limited data exists on the link between coronary remodeling and specific angina types.
Purpose of the Study:
- To investigate differences in coronary arterial remodeling among patients with distinct types of angina pectoris.
- To correlate coronary artery remodeling patterns with clinical manifestations of ischemic heart disease.
Main Methods:
- Intravascular ultrasound (IVUS) analysis of 100 ischemic heart disease patients.
- Measurement of intraluminal area (LA) and external elastic membrane (EEM) in reference and lesion segments.
- Calculation of a remodeling index to quantify arterial changes, with classification into de novo unstable angina, accelerating unstable angina, and stable angina groups.
Main Results:
- A significantly higher remodeling index was observed in the de novo unstable angina group compared to accelerating unstable angina and stable angina groups (p=0.0347 and p=0.0005).
- No significant difference in remodeling index was found between the accelerating unstable angina and stable angina groups.
Conclusions:
- Positive coronary arterial remodeling is more prevalent in patients with new-onset (de novo) angina pectoris.
- Specific patterns of coronary arterial remodeling may play a role in the clinical presentation of coronary artery disease.
Background:
Coronary arterial remodeling influences the clinical presentation of ischemic heart disease; however, there is little information on the relationship between coronary arterial remodeling and the type of angina pectoris that patients manifest.
Hypothesis:
The study was undertaken to determine the difference of coronary arterial remodeling in patients with different types of angina pectoris.
Methods:
We analyzed 100 patients with ischemic heart disease using intravascular ultrasound (IVUS). Intracoronary IVUS images of proximal reference (PR), distal reference (DR), and target lesion were recorded, and intraluminal area (LA) and external elastic membrane (EEM) were measured. We defined a remodeling index as 100 x (lesion EEM - [PR-EEM + DR-EEM]/2) / ([PR-EEM + DR-EEM]/2). Cases were classified into three groups according to the clinical history (Group 1a: de novo unstable angina pectoris, Group 1b: accelerating unstable angina pectoris, and Group 2; stable angina pectoris).
Results:
The remodeling index in Group 1a was significantly larger than that in Groups 1b and 2 (18.6 +/- 28.5 vs. 5.3 +/- 27.1 and 18.6 +/- 28.5 vs. -2.7 +/- 17.6, p = 0.0347 and p = 0.0005, respectively), but there was no statistical difference in remodeling index between Groups 1b and 2.
Conclusions:
Our results indicate that positive coronary arterial remodeling is more prevalent in patients with new onset of angina pectoris. The specific type of coronary arterial remodeling may affect the clinical presentation of patients with coronary artery disease.
