Artery Research (Dec 2017)

P81 DISARRAY AND REMODELING OF THE RADIAL ARTERY IN WOMEN WITH SPONTANEOUS CORONARY ARTERY DISSECTION: THE FUCHSIA STUDY

  • Rosa Maria Bruno,
  • Nicole Di Lascio,
  • Abtehale Al Hussaini,
  • Daniela Guarino,
  • Saverio Vitali,
  • Piercarlo Rossi,
  • Davide Caramella,
  • Bernardo Cortese,
  • Francesco Faita,
  • Stefano Taddei,
  • Lorenzo Ghiadoni,
  • David Adlam

DOI
https://doi.org/10.1016/j.artres.2017.10.097
Journal volume & issue
Vol. 20

Abstract

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Background: Spontaneous coronary dissection (SCAD) may represent a manifestation of fibromuscular dysplasia (FMD); thus, preclinical lesions might be found in extracoronary vessels with similar size and wall ultrastructure, such as the radial artery. Methods: Two 5′-clips from the left radial artery were obtained by Vevo MD (70 MHz probe, FUJIFILM, VisualSonics). Radial wall showed two echogenic interfaces: the 1st (lumen-media) and the 2nd (media-adventitia). Intima-media (IMT), adventitia (AT), and global thickness (IMAT) and wall cross-sectional area (WCSA) Measured. Vascular wall disarray was assessed calculating the root mean square error (RMSE) between 20 gray-level profiles crossing the two interfaces and the profile obtained averaging them, normalized for the maximum value of the corresponding mean profile (RMSE/mean). Results: 5 female SCAD patients and 9 healthy controls (C) were enrolled (age 45±9 vs 45±13years, p = 0.95; BMI 21±3 vs 23±kg/mq, p = 0.22; mean BP 77±5 vs 85±10 mmHg, p = 0.053). 2nd interface peak was reduced in the SCAD group (97±29 130±19, p = 0.04), whereas RMSE/mean was increased (1.89±0.68 vs 0.97±0.30, p = 0.02). Similar values were found for the 1st interface. IMT (0.165±0.031 vs 0.125±0.022mm, p = 0.03), but not AT (0.095±0.020 vs 0.081±0.020mm, p = 0.20) and IMAT (0.260±0.049 vs 0.206±0.030mm, p = 0.053), was significantly higher in SCAD. Radial internal diameter and wall/lumen ratio were similar: conversely WCSA was increased in SCAD (1.69±0.48 vs 1.07±0.37mm2, p = 0.02). Conclusions: Radial arteries of SCAD patients were characterized by increased wall thickness. Furthermore, the 2nd echogenic layer exhibited loss of echogenicity and inhomogeneity, features similar to FMD patients.