Real-time Three-dimensional Echocardiographic Assessment of Left Ventricular Remodeling Index in Patients with Hypertensive Heart Disease and Coronary Artery Disease

Left ventricular remodeling index （LVRI） was assessed in patients with hypertensive heart disease （HHD） and coronary artery disease （CAD） by real-time three-dimensional echocardiography （RT3DE）. RT3DE data of 18 patients with HHD, 20 patients with CAD and 22 normal controis （NC） were acquired. Left ventricular end-diastolic volume （EDV） and left ventricular end-diastolic epicardial volume （EDVepi） were detected by RT3DE and two-dimensional echocardiography Simpson biplane method （2DE）. LVRI （left ventricular mass/EDV） was calculated and compared. The results showed that LVRI measurements detected by RT3DE and 2DE showed significant differences inter-groups （P〈0.01）. There was no significant difference in NC group （P〉0.05）, but significant difference in HHD and CAD intra-group （P〈0.05）. There was good positive correlations between LVRI detected by RT3DE and 2DE in NC and HHD groups （t=0.69, P〈0.01; r=0.68, P〈0.01）, but no significant correlation in CAD group （r=0.30, P〉0.05）. It was concluded that LVRI derived from RT3DE as a new index for evaluating left ventricular remodeling can provide more superiority to LVRI derived from 2DE.

Coronary plaque characterization of nonculprit or nontarget lesions assessed by analysis of in vivo intracoronary ultrasound radio-frequency data

Background Unheralded sudden death and acute myocardial infarction are common manifestations of coronary atherosclerosis. Such events are related to thrombotic occlusion at the site of non-flow limiting atherosclerotic plaques in epicardial coronary arteries. This study aimed to assess plaque characterization of nonculprit lesions in patients with acute coronary syndrome （ACS） compared with those with stable angina pectoris （SAP） determined by analysis of intravascular ultrasound （IVUS） radiofrequency （RF） data. Methods In 81 patients, nonculprit vessels with 〈50% diameter stenosis and nontarget segment of culprit vessels with 〈50% diameter stenosis were studied with IVUS. Tissue maps were reconstructed from RF data using IVUS-Virtual Histology software. Results Mean lipid core percentage was significantly higher in patients with ACS than in those with SAP （（25.78±6.30）% vs （9.11±4.90）%, P 〈0.001）. In addition, patients with SAP showed more fibrotic vessels （（59.66±16.87）% vs （49.07±10.20）%, P 〈0.001）. There was no significant difference in either mean calcium （（4.37±2.40）% vs （5.12±3.00）%, P=-0.225） or fibrolipid （（24.94±9.40）% vs （25.82±13.60）%, P=0.731） percentages in nonculprit vessels, but the mean calcium percentage was significantly higher in nontarget lesions of culprit vessels （（5.51±3.29）% vs （3.57±2.10）%, P=0.003）. In addition, there was a positive correlation between lipid core and remodeling index （RI） （r=0.847, P〈0.001） and a negative correlation between fibrous tissue and RI （r= -0.946, P〈0.001）. Conclusions In this study, in both nonculprit vessels and nontarget lesion of culprit vessels, plaque characterization of nonculprit lesions determined by spectral analysis of IVUS RF data was significantly different in patients with ACS. The percentage of lipid core was significantly higher in patients with ACS than in those with SAP. Conversely, SAP patients showed more fibrotic content. In vivo plaque composition and morphological changes were related to remodeling of the coronary artery tree.