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

Background: Previous 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. Methods: We 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: nondiabetic (non-DM: 112 vessels, 93 patients) and diabetic (DM: 63 vessels, 53 patients). Results: In 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 mm(2) vs. 0.58 +/- 0.41 mm(2), p < 0.001, and 2.42 +/- 1.65 mm(2) vs. 1.46 +/- 1.76 mm(2), 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 nnm(3) vs. 8.18 +/- 6.24 mm(3), p < 0.01, and 29.99 +/- 28.90 mm(3) vs. 19.44 +/- 19.35 mm(3), 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). Conclusion: Characterization of coronary plaque by iMAP-IVUS in diabetic patients showed increased lipidic amount and necrotic plaque volume relative to subjects without DM. (C) 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.