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A Novel Algorithm to Quantify Coronary Remodeling Using Inferred Normal Dimensions

Author(s)
Falcão, Breno A. A.; Falcão, João Luiz A. A.; Morais, Gustavo R.; Silva, Rafael C.; Lopes, Augusto Celso de Araujo; Soares, Paulo R.; Mariani, Jose; Kalil-Filho, Roberto; Edelman, Elazer R.; Lemos, Pedro A.; ... Show more Show less
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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. Conclusions: Quantitative assessment of coronary remodeling using target segment dimensions offers a promising approach to evaluate the vessel response to plaque growth/regression.
Date issued
2015-04
URI
http://hdl.handle.net/1721.1/102791
Department
Institute for Medical Engineering and Science
Journal
Arquivos Brasileiros de Cardiologia
Publisher
SciELO
Citation
Falcão, Breno A. A., João Luiz A. A. Falcão, Gustavo R. Morais, Rafael C. Silva, Augusto C. Lopes, Paulo R. Soares, José Mariani, Roberto Kalil-, Elazer R. Edelman, and Pedro A. Lemos. “A Novel Algorithm to Quantify Coronary Remodeling Using Inferred Normal Dimensions.” Arquivos Brasileiros de Cardiologia (2015)105:4 p.390-398.
Version: Author's final manuscript
ISSN
0066-782X

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