Associação entre remodelamento vascular e núcleo necrótico em artérias coronárias: análise por ultrassom intracoronário com Histologia Virtual®

Abstract

background: Anatomopathological studies suggest an as sociation of positive vascular remodeling and vulnerable coronary plaques. The objective of this study was to verify whether there is a correlation between positive vascular remodeling and necrotic core in atherosclerotic coronary lesions. Methods: We studied 270 cross sections obtained by Virtual Histology ® in 30 patients who had positive re modeling in coronary artery segments with lesions > 50%, identified by coronary angiography. Seven cross sections were assessed per segment of coronary artery, including the cross section with the highest remodeling index, denominated cross section of interest (cross section 4). Results: Mean age was 60.8 ± 8.8 years, 80% were male and 30% were diabetic. Unstable angina was the most frequent clinical presentation (56.6%) and the left anterior descending artery was the most analyzed vessel (43%). The vessel reference area was 15.5 ± 4.9 mm² and the remodeling index in cross section 4 was 1.2 ± 0.1. Repeated measures analysis of variance showed a higher percentage of necrotic core in the cross section of interest (P < 0.001). We observed a positive correlation of coronary artery remodeling and necrotic core (r = 0.79; P < 0.001). Conclusions: Positive coronary artery remodeling is associated to the presence of necrotic core, which characterizes vulnerable athe rosclerotic plaques. The search for positive arterial remo