Composition of coronary atherosclerotic plaque in the intima and media affects intravascular ultrasound measurements of intimal thickness

Thomas Richard Porter, Stanley J Radio, James A. Anderson, Alan Michels, Feng Xie

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Abstract

Objectives. The purpose of this study was to evaluate how intravascular ultrasound-determined thickness and reflectivity of the inner echogenic layer of coronary artery plaque is affected by changes in collagen, elastin, proteoglycan, calcium and lipid content in the intima and media. Background. Coronary artery plaque often results in disruption of the internal elastic lamina and in increased collagen in the media as well as increased intimal lipid, calcium and proteoglycan content. How these factors affect intravascular ultrasound-derived measurements of intimal thickness are unknown. Methods. Twenty-one coronary artery segments from 10 patients with varying degrees of coronary artery disease were obtained fresh and unfixed at autopsy. Instravascular ultrasound (30-MHz, 3.5F catheter) was performed at regions in the vessel where a three-layered region was evident. Quantitative measurements of inner echogenic and deeper echolucent layer thickness were determined as well as estimates of ultrasound reflectivity and compared with histologic measurments of intimal and medial thickness and collagen, proteoglycan, lipid and calcium content. Results. In plaque >300 μm thick and equivalent histologic levels of collagen, inner echogenic layer reflectivity was greater in regions with a greater amount of calcium and proteoglycan and lesser amounts of lipid. Inner echogenic layer thickness correlated well with intimal thickness but had the best correlation with intimal and medial thickness when medial collagen content was increased (r = 0.89). The median observed difference between intimal and inner echogenic thickness was 160 (p < 0.05 compared with zero), whereas the median observed difference between inner echogenic thickness and intimal plus medial thickness when medial collagen content was increased was 60 (not significantly different from zero). Conclusions. The inner echogenic layer of human coronary artery plaque may represent both intima and media. The echolucent layer by ultrasound may represent only the basal section of the media that does not contain high collagen contest.

Original languageEnglish (US)
Pages (from-to)1079-1084
Number of pages6
JournalJournal of the American College of Cardiology
Volume23
Issue number5
DOIs
StatePublished - Jan 1 1994

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Tunica Intima
Atherosclerotic Plaques
Collagen
Proteoglycans
Coronary Vessels
Calcium
Lipids
Elastin
Coronary Artery Disease
Autopsy
Catheters

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Composition of coronary atherosclerotic plaque in the intima and media affects intravascular ultrasound measurements of intimal thickness",
abstract = "Objectives. The purpose of this study was to evaluate how intravascular ultrasound-determined thickness and reflectivity of the inner echogenic layer of coronary artery plaque is affected by changes in collagen, elastin, proteoglycan, calcium and lipid content in the intima and media. Background. Coronary artery plaque often results in disruption of the internal elastic lamina and in increased collagen in the media as well as increased intimal lipid, calcium and proteoglycan content. How these factors affect intravascular ultrasound-derived measurements of intimal thickness are unknown. Methods. Twenty-one coronary artery segments from 10 patients with varying degrees of coronary artery disease were obtained fresh and unfixed at autopsy. Instravascular ultrasound (30-MHz, 3.5F catheter) was performed at regions in the vessel where a three-layered region was evident. Quantitative measurements of inner echogenic and deeper echolucent layer thickness were determined as well as estimates of ultrasound reflectivity and compared with histologic measurments of intimal and medial thickness and collagen, proteoglycan, lipid and calcium content. Results. In plaque >300 μm thick and equivalent histologic levels of collagen, inner echogenic layer reflectivity was greater in regions with a greater amount of calcium and proteoglycan and lesser amounts of lipid. Inner echogenic layer thickness correlated well with intimal thickness but had the best correlation with intimal and medial thickness when medial collagen content was increased (r = 0.89). The median observed difference between intimal and inner echogenic thickness was 160 (p < 0.05 compared with zero), whereas the median observed difference between inner echogenic thickness and intimal plus medial thickness when medial collagen content was increased was 60 (not significantly different from zero). Conclusions. The inner echogenic layer of human coronary artery plaque may represent both intima and media. The echolucent layer by ultrasound may represent only the basal section of the media that does not contain high collagen contest.",
author = "Porter, {Thomas Richard} and Radio, {Stanley J} and Anderson, {James A.} and Alan Michels and Feng Xie",
year = "1994",
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TY - JOUR

T1 - Composition of coronary atherosclerotic plaque in the intima and media affects intravascular ultrasound measurements of intimal thickness

AU - Porter, Thomas Richard

AU - Radio, Stanley J

AU - Anderson, James A.

AU - Michels, Alan

AU - Xie, Feng

PY - 1994/1/1

Y1 - 1994/1/1

N2 - Objectives. The purpose of this study was to evaluate how intravascular ultrasound-determined thickness and reflectivity of the inner echogenic layer of coronary artery plaque is affected by changes in collagen, elastin, proteoglycan, calcium and lipid content in the intima and media. Background. Coronary artery plaque often results in disruption of the internal elastic lamina and in increased collagen in the media as well as increased intimal lipid, calcium and proteoglycan content. How these factors affect intravascular ultrasound-derived measurements of intimal thickness are unknown. Methods. Twenty-one coronary artery segments from 10 patients with varying degrees of coronary artery disease were obtained fresh and unfixed at autopsy. Instravascular ultrasound (30-MHz, 3.5F catheter) was performed at regions in the vessel where a three-layered region was evident. Quantitative measurements of inner echogenic and deeper echolucent layer thickness were determined as well as estimates of ultrasound reflectivity and compared with histologic measurments of intimal and medial thickness and collagen, proteoglycan, lipid and calcium content. Results. In plaque >300 μm thick and equivalent histologic levels of collagen, inner echogenic layer reflectivity was greater in regions with a greater amount of calcium and proteoglycan and lesser amounts of lipid. Inner echogenic layer thickness correlated well with intimal thickness but had the best correlation with intimal and medial thickness when medial collagen content was increased (r = 0.89). The median observed difference between intimal and inner echogenic thickness was 160 (p < 0.05 compared with zero), whereas the median observed difference between inner echogenic thickness and intimal plus medial thickness when medial collagen content was increased was 60 (not significantly different from zero). Conclusions. The inner echogenic layer of human coronary artery plaque may represent both intima and media. The echolucent layer by ultrasound may represent only the basal section of the media that does not contain high collagen contest.

AB - Objectives. The purpose of this study was to evaluate how intravascular ultrasound-determined thickness and reflectivity of the inner echogenic layer of coronary artery plaque is affected by changes in collagen, elastin, proteoglycan, calcium and lipid content in the intima and media. Background. Coronary artery plaque often results in disruption of the internal elastic lamina and in increased collagen in the media as well as increased intimal lipid, calcium and proteoglycan content. How these factors affect intravascular ultrasound-derived measurements of intimal thickness are unknown. Methods. Twenty-one coronary artery segments from 10 patients with varying degrees of coronary artery disease were obtained fresh and unfixed at autopsy. Instravascular ultrasound (30-MHz, 3.5F catheter) was performed at regions in the vessel where a three-layered region was evident. Quantitative measurements of inner echogenic and deeper echolucent layer thickness were determined as well as estimates of ultrasound reflectivity and compared with histologic measurments of intimal and medial thickness and collagen, proteoglycan, lipid and calcium content. Results. In plaque >300 μm thick and equivalent histologic levels of collagen, inner echogenic layer reflectivity was greater in regions with a greater amount of calcium and proteoglycan and lesser amounts of lipid. Inner echogenic layer thickness correlated well with intimal thickness but had the best correlation with intimal and medial thickness when medial collagen content was increased (r = 0.89). The median observed difference between intimal and inner echogenic thickness was 160 (p < 0.05 compared with zero), whereas the median observed difference between inner echogenic thickness and intimal plus medial thickness when medial collagen content was increased was 60 (not significantly different from zero). Conclusions. The inner echogenic layer of human coronary artery plaque may represent both intima and media. The echolucent layer by ultrasound may represent only the basal section of the media that does not contain high collagen contest.

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EP - 1084

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JF - Journal of the American College of Cardiology

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