Intravascular Ultrasound for the Evaluation of Therapies Targeting Coronary Atherosclerosis
Dirk Böse, MD*,
Clemens von Birgelen, MD, PhD and
Raimund Erbel, MD*,*
* Department of Cardiology, University of Duisburg-Essen, Essen, Germany
Department of Cardiology, Medisch Spectrum Twente, Enschede, the Netherlands.
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Figure 1 IVUS Cross-Sectional Image of an Atherosclerotic Human Coronary Artery
Determination of plaque cross-sectional area using intravascular ultrasound (IVUS): external elastic membrane (EEM)–cross-sectional area (CSA) – Lumen-CSA = Plaque + Media-CSA.
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Figure 2 IVUS Cross-Sectional Image and Longitudinal Reconstruction of an Atherosclerotic Coronary Artery With a Plaque Rupture
(Left) Intravascular ultrasound (IVUS) cross-sectional image; (right) longitudinal reconstruction. The line indicates the position of the cross-sectional image and thus the site of plaque rupture in the longitudinal reconstruction.
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Figure 3 Plaque Progression/Regression Versus CV Events
Higher rate of cardiovascular (CV) events in patients with plaque progression during follow-up. Modified from von Birgelen et al. (27). PCI = percutaneous coronary intervention; P&M = plaque and media.
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Figure 4 Cholesterol Levels Versus Plaque Progression Regression
(Top) Positive relation between plaque progression, defined as change in plaque plus media cross-sectional area/year ( P&M CSA/year), versus LDL-C levels. (Bottom) Negative relation between plaque progression (P&M CSA/year) versus HDL-C levels. Modified from von Birgelen et al. (33). CSA = cross-sectional area; HDL-C = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; P&M = plaque and media.
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Figure 5 LDL-C Versus Coronary Plaque Progression/Regression
(Left) First demonstration of the positive correlation between coronary plaque progression by intravascular ultrasound and LDL-C levels in an observational study. Modified from von Birgelen et al. (33). (Right) Confirmation of the relation between LDL-C and coronary plaque progression by data derived from various large randomized trials. Modified from Nissen SE et al. (36). LDL-C = low-density lipoprotein cholesterol; P&M = plaque and media.
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