Association of Plaque Composition and Vessel Remodeling in Atherosclerotic Renal Artery StenosisA Comparison With Coronary Artery Disease
Tetsuro Kataoka, MD*,
Verghese Mathew, MD, FACC*,
Ronen Rubinshtein, MD*,
Charanjit S. Rihal, MD, FACC*,
Ryan Lennon, MS ,
Lilach O. Lerman, MD, PhD ,
Amir Lerman, MD, FACC*,*
* Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
Section of Biostatistics, Mayo Clinic, Rochester, Minnesota
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
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Figure 1 Pie Diagram Describing the Distribution of VH Plaque Component
Virtual histology (VH) plaque components are displayed fibrous in red, fibro-fatty in yellow, dense calcium in white, and necrotic core in orange. (A) VH plaque components of renal artery stenosis (RAS) lesions. (B) VH plaque components of coronary artery disease (CAD) lesions. Fibrous plaque was the most prominent plaque composition, followed by fibro-fatty plaque, necrotic core, and dense calcium in both lesions.
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Figure 2 Adaptive Vessel Enlargement for Different Plaque Burdens
Upper panels show the correlations between vessel area and plaque area in RAS lesions. (A) The adaptive vessel enlargement in slices with plaque burden <40% in RAS lesions. The degree of adaptive vessel enlargement is 1.11 mm2. (B) In slices with plaque burden >40% in RAS lesions, the degree is 0.63 mm2. Lower panels show the correlations in patients with CAD lesions. (C) In slices with plaque burden <40% in CAD lesions, the degree is 1.32 mm2. (D) In slices with plaque burden >40% in CAD lesions, the degree is 0.83 mm2. Abbreviations as in Figure 1.
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Figure 3 Adaptive Vessel Enlargement for Plaque Components in RAS Lesions
Panels show the correlation between vessel area and virtual histology plaque components in renal artery stenosis (RAS) lesions. (A) The correlation between vessel area and the area of fibrous tissue. The degree adapting vessel enlargement is 0.52 mm2. (B) The degree for fibro-fatty tissue is 0.42 mm2. (C) The degree for necrotic core is 1.65 mm2. (D) The degree for dense calcium is 4.33 mm2.
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Figure 4 Adaptive Vessel Enlargement for Plaque Components in CAD Lesions
Panels show the correlation between vessel area and virtual histology plaque components in coronary artery disease (CAD) lesions. (A) The correlation between vessel area and the area of fibrous tissue. The degree adapting vessel enlargement is 0.92 mm2. (B) The degree for fibro-fatty tissue is 1.25 mm2. (C) The degree for necrotic core is 2.01 mm2. (D) The degree for dense calcium is 1.04 mm2.
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Figure 5 Examples of VH-IVUS Images in RAS Patients
Upper panels show a set of example of virtual histology-intravascular ultrasound imaging (VH-IVUS) images with negative remodeling. (A) The image at the site with minimum lumen area in the vessel with negative remodeling. (B) At the reference in the vessel with negative remodeling. Lower panels show a set of examples with positive remodeling. (C) At the minimum lumen area in the vessel with positive remodeling. (D) At the reference in the vessel with positive remodeling. RAS = renal artery stenosis.
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Figure 6 Examples of VH-IVUS Images in CAD Patients
Upper panels show a set of example of virtual histology-intravascular ultrasound imaging (VH-IVUS) images with negative remodeling. (A) The image at the site with minimum lumen area in the vessel with negative remodeling. (B) At the reference in the vessel with negative remodeling. Lower panels show a set of examples with positive remodeling. (C) At the site with minimum lumen area in the vessel with positive remodeling. (D) At the reference in the vessel with positive remodeling. CAD = coronary artery disease.
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Figure 7 Comparison of the Area of VH Plaque Components Between Remodeling Patterns
Intermediate/negative remodeling group is displayed in red bars and positive remodeling group is displayed in gold bars. (A) Comparison of the area of VH components in RAS lesions. (B) The percent area of VH components in RAS lesions. (C) The area of VH plaque components in CAD lesions. (D) The percent area of VH plaque components in CAD lesions. Abbreviations as in Figure 1.
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