Background Few studies have examined plaque characteristics among multiple arterial beds in vivo. The purpose of this study was to compare the plaque morphology and arterial remodeling between coronary and peripheral arteries using gray-scale and radiofrequency intravascular ultrasound (IVUS) at clinical presentation. Methods and Results IVUS imaging was performed in 68 patients with coronary and 93 with peripheral artery lesions (29 carotid, 50 renal, and 14 iliac arteries). Plaques were classified as fibroatheroma (VH-FA) (further subclassified as thin-capped [VH-TCFA] and thick-capped [VH-ThCFA]), fibrocalcific plaque (VH-FC) and pathological intimal thickening (VH-PIT). Plaque rupture (13% of coronary, 7% of carotid, 6% of renal, and 7% of iliac arteries; P=NS) and VHTCFA (37% of coronary, 24% of carotid, 16% of renal, and 7% of iliac arteries; p=0.02) were observed in all arteries. Compared with coronary arteries, VH-FA was less frequently observed in renal (p<0.001) and iliac arteries (p<0.006). Lesions with positive remodeling demonstrated more characteristics of VH-FA in coronary (84% vs. 25%, p<0.001), carotid (72% vs. 20%, p=0.001), and renal arteries (42% vs. 4%, p=0.001) compared with those with intermediate/negative remodeling. There was positive relationship between RI and percent necrotic area in all four arteries. Conclusions Atherosclerotic plaque phenotypes were heterogeneous among four different arteries; renal and iliac arteries had more stable phenotypes compared with coronary artery. In contrast, the associations of remodeling pattern with plaque phenotype and composition were similar among the various arterial beds.

Aim:The aim of this study was to investigate the role of uric acid (UA) in coronary endothelial function via its effects on renal function, other coronary risk factors and asymmetric dimethylarginine (ADMA) in men and women.

Temperature measurement of coronary plaque enables accurate localization of the culprit plaque in AMI with coronary total occlusion.

uick and accurate evaluation of coronary reperfusion in patients with acute myocardial infarction (AMI) is essential to determine whether thrombolysis and/or percutaneous coronary intervention (PCI) is required to achieve reperfusion. [1][2][3][4][5][6][7] Recent advancements in transthoracic Doppler echocardiography (TTDE) have enabled direct visualization and evaluation of coronary blood flow velocity, especially in the distal left anterior descending coronary artery (LAD). [8][9][10][11][12][13][14][15][16][17][18] This technique has been applied for noninvasive evaluation of Thrombolysis in Myocardial Infarction (TIMI) flow grade, which is widely used as a valuable index of coronary reperfusion. 19 Our previous study demonstrated that preserved coronary artery flow velocity as determined by TTDE enables differentiation of TIMI 3 from TIMI 0-2 in patients with anterior AMI before PCI. 20 However, the conventional TIMI classification is a semi-quantitative grading of coronary reperfusion after AMI and is thereby limited by its subjective and categorical nature. TIMI frame count by angiography is a simple, objective, reproducible and quantitative measure of coronary reperfusion 21 that allows for better prediction of clinical outcomes after AMI. 22 An intracoronary Doppler guidewire study has demonstrated that distal coronary flow velocity inversely correlates with the TIMI frame count before PCI. 23 Therefore, we hypothesized that the measurement of LAD flow velocity by TTDE would enable quantitative evaluation of the TIMI frame count by angiography in patients with anterior AMI. To test this hypothesis, we prospectively compared reperfused distal LAD flow velocity by TTDE with the TIMI frame count by angiography in patients with anterior AMI before mechanical reperfusion therapy. Methods Study GroupBetween August 2001 and November 2003, 56 consecutive patients at the Department of Cardiology, Kagoshima City Hospital with a first anterior AMI before mechanical reperfusion were enrolled in the study. Inclusion criteria were: (1) typical chest pain lasting >30 min and <12 h from onset; (2) ST-segment elevation >0.2 mV in precordial leads; (3) subsequent increase in serum creatine kinase ≥2- Methods and ResultsColor and pulsed TTDE was performed to evaluate distal left anterior descending coronary artery (LAD) reperfusion in 56 consecutive patients with a first anterior AMI before coronary intervention, and these findings were compared with the corrected TIMI frame count (cTFC) by subsequent angiography. Twenty-four of the 56 patients had LAD reperfusion (TIMI 2 or 3) by angiography. Visual antegrade distal LAD flow by color TTDE was detected in 21 of these 24 patients. In the 21 patients, diastolic peak velocity of the distal LAD flow by pulsed TTDE showed a significant correlation with cTFC by angiography (r=-0.74, p<0.001). The diagnosis of high risk with angiographic cTFC >40 by distal LAD peak velocity <21 cm/s using TTDE had a sensitivity, specificity, and accuracy of 82%, 93%, and 91%, respectively. Concl...

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