Related Experiment Video

Updated: Jul 22, 2025

Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus
06:43

Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus

Published on: December 7, 2013

13.8K

Coronary Atherosclerosis Phenotypes in Focal and Diffuse Disease

Koshiro Sakai1, Takuya Mizukami2, Jonathon Leipsic3

  • 1Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan.

JACC. Cardiovascular Imaging
|July 22, 2023
PubMed

Insights

Focal coronary artery disease (CAD) shows higher plaque burden and lipid-rich plaques with thin-cap fibroatheroma (TCFA), while diffuse CAD has more calcifications. This links plaque characteristics to coronary hemodynamics.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • The relationship between coronary hemodynamics and atherosclerotic plaque characteristics is not fully understood.
  • Differentiating between focal and diffuse coronary artery disease (CAD) based on hemodynamics is crucial for understanding plaque behavior.

Purpose of the Study:

  • To compare atherosclerotic plaque phenotypes in focal versus diffuse CAD, as defined by coronary hemodynamics.
  • To investigate the association between pullback pressure gradient (PPG) and plaque morphology.

Main Methods:

  • A multicenter, prospective study included 117 patients with functionally significant lesions (FFR ≤0.80).
  • Plaque analysis utilized coronary computed tomography angiography (CCTA) and optical coherence tomography (OCT).
  • CAD patterns were assessed using motorized FFR pullbacks, quantifying focal vs. diffuse disease by median PPG.

Main Results:

  • Focal CAD exhibited higher plaque burden (87% vs. 82%, P=0.003) on CCTA.
  • Diffuse CAD showed significantly more calcifications (Agatston score: 158 vs. 51, P=0.024).
  • OCT revealed a higher prevalence of lipid-rich plaques (37% vs. 4%, P=0.001) and TCFAs (47% vs. 10%, P=0.002) in focal CAD.

Conclusions:

  • Atherosclerotic plaque phenotypes are associated with intracoronary hemodynamics.
  • Focal CAD is characterized by higher plaque burden and lipid-rich plaques with TCFAs.
  • Diffuse CAD is associated with more prevalent calcifications, highlighting distinct hemodynamic-morphological patterns.
Abstract

Keywords:
calcificationcoronary computed tomography angiographylipid-rich plaqueoptical coherence tomographypullback pressure gradientthin-cap fibroatheromas

More Related Videos

Quantitative Analysis of Cellular Composition in Advanced Atherosclerotic Lesions of Smooth Muscle Cell Lineage-Tracing Mice09:06

Quantitative Analysis of Cellular Composition in Advanced Atherosclerotic Lesions of Smooth Muscle Cell Lineage-Tracing Mice

Published on: February 20, 2019

8.3K
Quantification of Atherosclerosis in Mice06:59

Quantification of Atherosclerosis in Mice

Published on: June 12, 2019

37.7K

Related Concept Videos

Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
13
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
13
Atherosclerosis I: Introduction01:30

Atherosclerosis I: Introduction

Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
11
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
23
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
13
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
21