Visualization of coronary plaque in type 2 diabetes mellitus patients using a new 40MHz intravascular ultrasound imaging system

摘要

Background: Previous epidemiological studies demonstrated plaque vulnerability to be high in diabetic patients. iMap-intravascular ultrasound (IVUS) is a recently developed radiofrequency 40. MHz IVUS imaging system for tissue characterization. This study aimed to characterize coronary plaque in target lesions of diabetic patients using iMap-IVUS. Methods: We studied 175 treated vessels in 146 patients with stable angina pectoris and analyzed plaque components of culprit lesions by iMAP-IVUS. Patients were divided into 2 groups: non-diabetic (non-DM: 112 vessels, 93 patients) and diabetic (DM: 63 vessels, 53 patients). Results: In gray-scale IVUS 2D analysis, there were no differences in IVUS parameters. In 3D analysis, the DM group tended to have a larger plaque volume (p=0.07) and plaque burden (p=0.10). At minimum lumen sites, the absolute lipidic and necrotic areas (0.84±0.44mm 2 vs. 0.58±0.41mm 2, p0.001, and 2.42±1.65mm 2 vs. 1.46±1.76mm 2, p0.001, respectively) and percent lipidic and necrotic areas were significantly greater in the DM than in the non-DM group (8.39±3.38% vs. 5.25±2.30%, p0.0001, and 23.65±11.54% vs. 12.99±10.71%, p0.0001, respectively). In addition, the absolute lipidic and necrotic volumes (11.75±10.59mm 3 vs. 8.18±6.24mm 3, p0.01, and 29.99±28.90mm 3 vs. 19.44±19.35mm 3, p0.01, respectively) and percent lipidic and necrotic volumes were significantly greater in the DM than in the non-DM group (6.27±1.92% vs. 5.13±1.82%, p0.0001, and 16.54±7.56% vs. 12.08±6.05%, p0.0001, respectively). Conclusion: Characterization of coronary plaque by iMAP-IVUS in diabetic patients showed increased lipidic amount and necrotic plaque volume relative to subjects without DM.