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. 2018 Dec;15(12):738-743.
doi: 10.11909/j.issn.1671-5411.2018.12.005.

Characterization of coronary atherosclerotic plaques in a homozygous familial hypercholesterolemia visualized by optical coherence tomography

Ze-Sen Liu  1 , Jie Peng  2 , Shi-Long Wang  2 , Tao Jiang  3 , Jie Lin  2 , Kang Meng  1
Affiliations

Characterization of coronary atherosclerotic plaques in a homozygous familial hypercholesterolemia visualized by optical coherence tomography

Ze-Sen Liu et al. J Geriatr Cardiol. 2018 Dec.
No abstract available

Keywords: Coronary atherosclerotic plaques; Homozygous familial hypercholesterolemia; Optical coherence tomography.

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Figures

Figure 1.
Figure 1.. Multiple xanthomas in the elbows, about 1.0–3.5 cm in diameter.
Figure 2.
Figure 2.. Sequence with mutation and pedigree of his family members.
(A): The sequence of 1470 G >A nonsense mutation in exon 10 resulting in W469X; (B): the proband was indicated with an arrow. Squares indicate men; circles, women; deceased persons were indicated by a diagonal line drawn through the symbol. LDL-C: low-density lipoprotein cholesterol.
Figure 3.
Figure 3.. The results of lipid levels among nine years follow-up.
HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; TC: total cholesterol; TG: triglyceride.
Figure 4.
Figure 4.. The result of echocardiography.
(A): Left ventricle ejection fraction was 68.9% with no wall motion abnormalities; (B): severe aortic valve calcification was found in non-coronary cusp (white arrow head); (C): severe aortic valve calcification was found in Left coronary cusp (white arrow head).
Figure 5.
Figure 5.. The results of CTCA.
(A): Multiple calcified plaques were noted in the aortic root and a non-calcified plaque was noted in the origin of RCA (white arrow head); (B): multiple mixed plaques and calcified plaque were noted all across RCA. The calcified plaque located in the middle of the RCA resulted in severe stenosis (white arrow head); (C): the main segment of the left coronary is normal. Multiple calcified plaques and non-calcified plaques were noted in the proximal segment of LAD, which resulted in severe stenosis (white arrowhead); (D): multiple non-calcified plaques were noted in the proximal. CTCA: computed tomography coronary angiography; LAD: left anterior descending; LCX: left circumflex artery; RCA: right coronary artery.
Figure 6.
Figure 6.. The results of CAG.
(A): Diffuse stenosis in proximal and middle LAD, with the uttermost of 90% stenosis; (B): the distal of LCX was total occlusion; (C): diffuse stenosis all across RCA, with 90% stenosis in middle and distal RCA; (D): a stent was implanted in the culprit lesion of LAD (arrow head); (E): two stents were implanted in the RCA (arrow head). LAD: left anterior descending; RCA: right coronary artery.
Figure 7.
Figure 7.. OCT finding of RCA and LAD.
(A): An intact three-layer structure of the vessel wall; (B): a thin-cap fibroatheroma was located in the middle segment of RCA. The least fibrous cap thickness was 40 µm and the lipid core occupied two quadrants; (C): fibrous hyperplasia mixed with calcification in the narrowest part of RCA; (D): severe fibrous hyperplasia; (E): an intact three-layer structure of the vessel wall; (F): lipid plaque accompanied with inflammatory cell infiltration; (G): a large lipid plaque in the narrowest site of LAD; (H): mixed plaque accompanied with inflammatory cell infiltration; (I): calcified plaque; (J): normal vessel. LAD: left anterior descending; OCT: optical coherence tomography; RCA: right coronary artery.
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