Assessment of culprit lesions by intravascular ultrasound in patients with acute myocardial infarction

作     者：LIU Jian LIU Chuan-fen LU Ming-yu MA Yu-liang WANG Long CHEN Hong WANG Wei-min 

作者机构：Heart Center Peking University People's Hospital Beijing 100044 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2009年第122卷第6期

页      面：665-669页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：acute myocardial infarction culprit lesion intravascular ultrasound 

摘      要：Background Intravascular ultrasound has become the standard invasive method for diagnosing coronary artery disease. The aim of the present study was to evaluate the ability of intravascular ultrasound for assessment of culprit lesion morphology during primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods We performed 18 intravascular ultrasound assessments preintervention during the primary PCi for AMI. intravascular ultrasound analysis included qualitative and quantitative measurements of reference and lesion external elastic membrane （EEM）, lumen, and plaque plus media （P＆M） area. Positive remodeling was defined as lesion/mean reference EEM 〉1.0. Culprit lesions were identified by a combination of electrocardiogram （ECG） and coronary angiography. Results There was an average of- 1.44 infarct-related artery （IRA） plaques per patient. The incidences of thrombus and plaque ruptures were 28% （5） and 33% （6）, respectively. Hypoechoic plaque was observed in 72% （13） of AMI patients. Calcified lesions could be found in 33% （6） of culprit lesions. Sixty percent of the culprit lesion sites presented with positive remodeling. Conclusions Intravascular ultrasound is a safe and feasible imaging modality in patients with AMI and can help identify plaque rupture, intracoronary thrombus or calcification. The culprit lesion site in AMI cases often presents with positive remodeling.