Navegando por Palavras-chave "Atherosclerotic"

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    Caracterização tecidual e fenotípica in vivo da placa aterosclerótica em pacientes com infarto agudo do miocárdio: análise pelo ultrassom intravascular utilizando o mapeamento tecidual iMAP®
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-11) Souza, Cristiano Freitas de [UNIFESP]; Carvalho, Antonio Carlos de Camargo [UNIFESP]; http://lattes.cnpq.br/6569055379421505; http://lattes.cnpq.br/2847246252774147; Universidade Federal de São Paulo (UNIFESP)
    Background: There is limited data on plaque tissue characterization and phenotype classification using radiofrequency iMAP-IVUS?. Methods: In the iWonder study patients presenting with non-ST-elevation myocardial infarction (STEMI) or STEMI underwent 3-vessel grayscale IVUS and iMAP-IVUS? tissue characterization prior to percutaneous intervention. In total, 385 lesions from 100 patients were divided into culprit (n=100) and non-culprit (n=285) lesions. Lesion phenotype was classified in a hierarchical fashion into: (1) TCFA (thin-cap fibroatheroma ? at least 1 frame with >30° of necrotic core [NC] abutting to the lumen); (2) ThCFA (NC >10%, confluent dense calcium [DC] >10%, well-defined fibrous cap); (3) PIT (pathological intimal thickening ? mainly fibrofatty tissue, <10% confluent NC); (4) fibrotic plaque (mainly fibrous tissue, <10% confluent NC, <10% confluent DC) and (5) fibrocalcific plaque (mainly fibrous tissue, >10% confluent DC and <10% confluent NC). Results: Culprit lesions had smaller minimum lumen area with greater plaque burden compared to non-culprit lesions. Volumetric analysis showed that culprit lesions had longer length and larger vessel and plaque volumes compared to non-culprit lesions. iMAP-IVUS? revealed that culprit lesions presented more NC and fibrofatty volume, both at lesion level and at the minimum lumen area (MLA) site (all p<0.001). Any fibroatheroma was more frequently identified in the culprit lesions compared to non-culprit lesions (93% vs. 78.9%, p=0.001). Also, a TCFA was more prevalent within culprit vs. non-culprit lesions (39.0% vs. 19.0%, p<0.001) anywhere within the lesion as well as at the MLA site (18.0% vs. 9.5%, p=0.07). Conclusion: Three-vessel radiofrequency iMAP-IVUS? study demonstrated a greater plaque burden and higher prevalence of any fibroatheroma as well as TCFAs in culprit vs non-culprit lesions in patients presenting with STEMI or non-STEMI and undergoing percutaneous intervention.