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A Method to Study the Correlation Between Local Collagen Structure and Mechanical Properties of Atherosclerotic Plaque Fibrous Tissue
Published on: November 11, 2022
Analysis of the relationship between the inner structure and the magnitude of atherosclerotic plaques
Maria Bogdan1, Jacek Kubica, Elena Weber
1Department of Cardiology and Internal Medicine, Medical University, Bydgoszcz, Poland. kikkardiol@amb.bygoszcz.pl
Insights
Intravascular ultrasound reveals that atherosclerotic plaque characteristics, including calcification and composition, significantly correlate with coronary artery narrowing. As artery narrowing increases, plaques become harder, more calcified, and concentric, indicating disease progression.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Pathology
Background:
- Ischaemic heart disease is a leading cause of mortality globally.
- Atherosclerotic plaque morphology is crucial in determining the severity of coronary artery stenosis.
- Understanding plaque characteristics can aid in risk stratification and treatment decisions.
Purpose of the Study:
- To evaluate the relationship between atherosclerotic plaque morphology and the degree of coronary artery lumen narrowing using intravascular ultrasound.
- To investigate how plaque composition (soft, mixed, hard), calcification, and location (concentric, eccentric) change with increasing stenosis severity.
Main Methods:
- Intravascular ultrasound (IVUS) was performed on 38 patients with symptomatic ischaemic heart disease.
- Patients were categorized into three groups based on coronary artery lumen narrowing: <50%, 50-75%, and >/=75%.
- Plaque morphology, including composition, calcification, and eccentricity, was analyzed and compared across the groups.
Main Results:
- Plaque structure significantly differed between narrowing groups (p<0.001).
- Soft plaques decreased while mixed, hard, and calcified plaques increased with greater lumen narrowing (p=0.0032 for calcification).
- Eccentric plaques were more common in lower-grade stenoses, while concentric plaques predominated in higher-grade stenoses (p<0.0018).
Conclusions:
- Intravascular ultrasound demonstrates significant correlations between plaque structure, calcification, location, and the degree of coronary artery lumen narrowing.
- Increasing lumen narrowing is associated with a progression towards harder, more calcified, and concentric plaques.
- These findings highlight the utility of IVUS in characterizing atherosclerotic disease severity and progression.
Abstract:
The aim of this study was ultrasound evaluation of atherosclerotic plaque morphology in relation to the degree of coronary artery lumen narrowing in patients with ischaemic heart disease. Intravascular ultrasound was performed on 38 patients (30 men and 8 women) aged 35 to 77 (average age 60 +/- 11 years old) with symptoms of ischaemic heart disease. The structure of atherosclerotic plaques with a degree of lumen narrowing of < 50% (1st group) was distinctly different from the structure of plaques with a degree of lumen narrowing of 50-75% (2nd group, p = 0.0045) and the structure of plaques with a degree of lumen narrowing of >/= 75% (3rd group, p < 0.001). The incidence of soft plaques decreased, whereas the percentage of mixed and hard plaques increased gradually with the increase in the degree of artery lumen narrowing. Significant differences in the incidence of plaque calcification were observed between the groups evaluated with crosssections of different degrees of lumen narrowing (p = 0.0032). The smallest number of calcifications was discovered in the 1st group as compared to the 2nd (p = 0.0027) and the 3rd group (p = 0.0026). With a higher degree of lumen narrowing, a lower percentage of eccentric plaques and a higher percentage of concentric plaques were observed. There were more eccentric plaques and fewer concentric plaques in cross-sections of the 1 st group as compared to the 2nd group (p = 0.0056) and the 3rd group (p = 0.0018). A comparison between the 2nd and 3rd groups showed no significant difference in the incidence of eccentric or concentric plaques (p = 0.5). In conclusion, intravascular ultrasound evaluation revealed significant relationships between the structure, presence of calcifications and location of atherosclerotic plaques and the degree of artery lumen narrowing. The incidence of mixed, hard, calcified and concentric plaques increased, whereas the percentage of soft, non-calcified and eccentric plaques decreased gradually with the increase in the degree of artery lumen narrowing.
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