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Detection of vulnerable plaques rather than the culprit lesions in patients with acute coronary syndrome using virtual histology intravascular ultrasound imaging

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Chinese Medical Journal 2009年第6期122卷 610-611页

作者： QIAN Ju-ying Department of Cardiology Zhongshan Hospital Fudan University Shanghai Institute of Cardiovascular Diseases Shanghai 200032 China

Pathology and postmortem studies have reported that the most important mechanism of acute coronary syndrome （ACS） is the rupture of a vulnerable plaque and subsequent thrombus formation. Such events commonly arise from the non-flow limiting atherosclerotic lesions which are prone to rupture. Thin-cap fibroatheromas （TCFA） are the most common type of vulnerable plaque. As the widely used technique for the detection of coronary arterial diseases, coronary angiography has intrinsic limitations since it only portrays the contrast agent-filled contour of the lumen and provides little information on the vessel wall and even less the characteristics of the plaques. Not surprisingly, angiography has low predictive value on the future ACS events. Intravascular ultrasound imaging （IVUS）, which supplies the cross-sectional imaging of the vessel from inside, provides both the topography of the vessel wall and the characteristics of atherosclerotic lesions,

关键词： stable angina-pectoris ATHEROSCLEROTIC PLAQUE RUPTURED PLAQUES

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HEMODYNAMIC ASSESSMENT OF INTRAVENOUS ISOSORBIDI DINITRAS IN CORONARY HEART DISEASE

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中华医学杂志(英文版) 1992年第2期105卷 159-162页

作者：戚文航钱溥 Shanghai Ruijin Hospital Shanghai Second Medical University200025

This study investigates the systemic hemodynamiceffects of intravenous Isosorbidi Dinitras,Isoket(ISDN)in 20 patients with coronary arterial disease totest the validity of the hypothesis concerning the reliefof myocardial *** were eligible for thestudy if they had angina with coronary angiographicrecords or if they were cases of *** and after ISDN infusion the follow-ing measurements were recorded or calculated:heartrate(HR);systolic,diastolic and mean aortic pressure(ASP,ADP,AP);systolic and mean pressure of theleft ventricle(LVSP,LVP);end-diastoic pressure inthe LV(LVEDP);left ventricular contractility(dp/dtmax);the double products (DP,HR ×LVSP) andmyocardial perfusion pressure in the LV(LVPP).Af-ter ISDN the ASP,AP and LVEDP decreased whileHR,ADP,dp/dt and DP showed no ***,LVEDP was significantly de-creased from 20±7 to 12±5 mmHg(P<0.01) withincreased LVPP from 49±12 to 56±13 mmHg(P<0.01),which may be favourable for the relief ofmyocardial *** was no significant changeof dp/dt max with decreased LVEDP after *** suggested that the left ventricle can maintain normalperformance at lower intracardial volume(preload)inthese patients.

关键词： stable angina-pectoris MYOCARDIAL-INFARCTION NITROGLYCERIN

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