Relationship between coronary remodeling and plaque characterization in patients without clinical evidence of coronary artery disease

Aims: The objectives of this study were: (1) to evaluate the relationship between coronary arterial remodeling assessed by intravascular ultrasound (IVUS) and plaque morphology assessed by histological examination in patients without clinical evidence of coronary artery disease and (2) to compare plaque morphology between histological examination and optical coherence tomography (OCT). Methods: Coronary segments (n = 98) were harvested from the heart of 34 patients who died without clinical evidence of coronary artery disease. The segments with remodeling were assessed by IVUS and compared with corresponding OCT and histological images. Results: The fibrofatty plaque area was larger in lesions with expansive remodeling (ER) than in lesions with intermediate/constrictive remodeling (IR/CR) (p < 0.01). Incidence of lipid containing plaque with the thickness of the fibrous cap smaller than 200 μm tended to be higher in ER than in IR/CR (34% versus 13%, p = 0.10). OCT assessment of lipid containing plaque with thinner fibrous cap was achieved with 92% sensitivity and 75% specificity. Conclusions: The fibrofatty plaque area was larger in lesions with ER than IR/CR even in patients without clinical evidence of coronary artery disease. The current capabilities of OCT are well suited for evaluation of lipid containing plaques with thinner fibrous cap.