Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Role of Intravascular Ultrasound in Patients with Acute Myocardial Infarction

  • Hong, Young Joon (Division of Cardiology of Chonnam National University Hospital, Heart Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Ahn, Youngkeun (Division of Cardiology of Chonnam National University Hospital, Heart Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Jeong, Myung Ho (Division of Cardiology of Chonnam National University Hospital, Heart Convergence Research Center Nominated by Korea Ministry of Health and Welfare)
  • Received : 2015.03.16
  • Accepted : 2015.04.14
  • Published : 2015.07.30
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Abstract

Rupture of a vulnerable plaque and subsequent thrombus formation are important mechanisms leading to the development of an acute myocardial infarction (AMI). Typical intravascular ultrasound (IVUS) features of AMI include plaque rupture, thrombus, positive remodeling, attenuated plaque, spotty calcification, and thin-cap fibroatheroma. No-reflow phenomenon was attributable to the embolization of thrombus and plaque debris that results from mechanical fragmentation of the vulnerable plaque by percutaneous coronary intervention (PCI). Several grayscale IVUS features including plaque rupture, thrombus, positive remodeling, greater plaque burden, decreased post-PCI plaque volume, and tissue prolapse, and virtual histology-IVUS features such as large necrotic core-containing lesion and thin-cap fibroatheroma were the independent predictors of no-reflow phenomenon in AMI patients. Non-culprit lesions associated with recurrent events were more likely than those not associated with recurrent events to be characterized by a plaque burden of ${\geq}70%$, a minimal luminal area of ${\leq}4.0mm^2$, or to be classified as thin-cap fibroatheromas.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea

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