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. 2015 Oct;105(4):390-8.
doi: 10.5935/abc.20150098. Epub 2015 Aug 18.

A Novel Algorithm to Quantify Coronary Remodeling Using Inferred Normal Dimensions

[Article in English, Portuguese]
Breno A A Falcão  1 , João Luiz A A Falcão  1 , Gustavo R Morais  1 , Rafael C Silva  1 , Augusto C Lopes  2 , Paulo R Soares  1 , José Mariani Jr  1 , Roberto Kalil-Filho  1 , Elazer R Edelman  2 , Pedro A Lemos  1
Affiliations

A Novel Algorithm to Quantify Coronary Remodeling Using Inferred Normal Dimensions

[Article in English, Portuguese]
Breno A A Falcão et al. Arq Bras Cardiol. 2015 Oct.

Abstract

Background: Vascular remodeling, the dynamic dimensional change in face of stress, can assume different directions as well as magnitudes in atherosclerotic disease. Classical measurements rely on reference to segments at a distance, risking inappropriate comparison between dislike vessel portions.

Objective: to explore a new method for quantifying vessel remodeling, based on the comparison between a given target segment and its inferred normal dimensions.

Methods: Geometric parameters and plaque composition were determined in 67 patients using three-vessel intravascular ultrasound with virtual histology (IVUS-VH). Coronary vessel remodeling at cross-section (n = 27.639) and lesion (n = 618) levels was assessed using classical metrics and a novel analytic algorithm based on the fractional vessel remodeling index (FVRI), which quantifies the total change in arterial wall dimensions related to the estimated normal dimension of the vessel. A prediction model was built to estimate the normal dimension of the vessel for calculation of FVRI.

Results: According to the new algorithm, "Ectatic" remodeling pattern was least common, "Complete compensatory" remodeling was present in approximately half of the instances, and "Negative" and "Incomplete compensatory" remodeling types were detected in the remaining. Compared to a traditional diagnostic scheme, FVRI-based classification seemed to better discriminate plaque composition by IVUS-VH.

Conclusion: Quantitative assessment of coronary remodeling using target segment dimensions offers a promising approach to evaluate the vessel response to plaque growth/regression.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Possible remodeling outcomes of a normal coronary vessel after the occurrence of atherosclerotic plaque. The figure shows the remodeling patterns classified according to the algorithm based on the fractional vessel remodeling index (FVRI). The numeric values are only illustrative. EEM: External elastic membrane.
Figure 2
Figure 2
Scatter correlation graph between estimated normal external elastic membrane area (EEM areaPREDICTED) and the actual lumen area in cross-sections with absent or trivial plaque (plaque burden < 20%).
Figure 3
Figure 3
Per cross-section (frames with plaque burden ≥ 20%) and per lesion types of vascular remodeling classified according to the algorithm based on fractional vessel remodeling index (FVRI).
Figure 4
Figure 4
Average fractional vessel remodeling index in relation to percent plaque burden (error bars are one standard error of the mean).
Figure 5
Figure 5
Plaque composition in vascular remodeling types according to fractional vessel remodeling index or classical remodeling index (FVRI) (n = 618 plaques).
See this image and copyright information in PMC

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