Clinical implications of carotid artery remodeling in acute coronary syndrome
Ultrasonographic assessment of positive remodeling
Masaya Kato, MD*,*,
Keigo Dote, MD*,
Seiji Habara, MD*,
Hiroaki Takemoto, MD*,
Kenji Goto, MD* and
Koichi Nakaoka, MD*
* Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
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Figure 1 How to measure the intima-media thickness (IMT), luminal diameter (LD), and interadventitial diameter (IAD). The distance from the luminal-intimal interface of the near wall to that of the far wall was defined as the LD, and the distance from the collagen-containing inner layer of the tunica adventitia of the near wall to that of the far wall was defined as the IAD.
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Figure 2 Frequency of soft plaques, hard plaques, and calcification in the common carotid artery. Acute coronary syndrome patients with multiple coronary plaques had more carotid plaques and calcification compared with patients who only had a single coronary plaque. There were no calcified hard carotid plaques in patients from the single-plaque group. Open bars = single-plaque group; closed bars = multiple-plaque group.
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Figure 3 Relationship between the mean of the maximum and minimum common carotid intima-media thickness values (IMTmean) and the interadventitial diameter (IAD) (top panel), and IMTmean and the ratio of IAD to the luminal diameter (LD) (bottom panel) in acute coronary syndrome patients. A significant positive correlation exists between IMTmean and IAD, and IMTmean and the ratio of IAD to LD.
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Figure 4 Typical B-mode ultrasonographic features of the common carotid arteries in acute coronary syndrome patients. Most patients with a solitary discrete coronary plaque had a normal intima-media thickness and no carotid enlargement (A). However, acute coronary syndrome patients with multiple or diffuse coronary plaques (B–F) showed carotid enlargement, an increase of intima-media thickness, soft plaques (*) (B, E), and hard plaques with calcification (arrows) in the more advanced stages of atherosclerosis (E, F).
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