Visualization of coronary plaque in type 2 diabetes mellitus patients using a new 40 MHz intravascular ultrasound imaging system

SummaryBackgroundPrevious epidemiological studies demonstrated plaque vulnerability to be high in diabetic patients. iMap-intravascular ultrasound (IVUS) is a recently developed radiofrequency 40 MHz IVUS imaging system for tissue characterization. This study aimed to characterize coronary plaque in target lesions of diabetic patients using iMap-IVUS.MethodsWe studied 175 treated vessels in 146 patients with stable angina pectoris and analyzed plaque components of culprit lesions by iMAP-IVUS. Patients were divided into 2 groups: non-diabetic (non-DM: 112 vessels, 93 patients) and diabetic (DM: 63 vessels, 53 patients).ResultsIn gray-scale IVUS 2D analysis, there were no differences in IVUS parameters. In 3D analysis, the DM group tended to have a larger plaque volume (p = 0.07) and plaque burden (p = 0.10). At minimum lumen sites, the absolute lipidic and necrotic areas (0.84 ± 0.44 mm2 vs. 0.58 ± 0.41 mm2, p < 0.001, and 2.42 ± 1.65 mm2 vs. 1.46 ± 1.76 mm2, p < 0.001, respectively) and percent lipidic and necrotic areas were significantly greater in the DM than in the non-DM group (8.39 ± 3.38% vs. 5.25 ± 2.30%, p < 0.0001, and 23.65 ± 11.54% vs. 12.99 ± 10.71%, p < 0.0001, respectively). In addition, the absolute lipidic and necrotic volumes (11.75 ± 10.59 mm3 vs. 8.18 ± 6.24 mm3, p < 0.01, and 29.99 ± 28.90 mm3 vs. 19.44 ± 19.35 mm3, p < 0.01, respectively) and percent lipidic and necrotic volumes were significantly greater in the DM than in the non-DM group (6.27 ± 1.92% vs. 5.13 ± 1.82%, p < 0.0001, and 16.54 ± 7.56% vs. 12.08 ± 6.05%, p < 0.0001, respectively).ConclusionCharacterization of coronary plaque by iMAP-IVUS in diabetic patients showed increased lipidic amount and necrotic plaque volume relative to subjects without DM.