Analysis Of The Characteristics Of Intravascular Ultrasound Images Of Patients Suffered From Angina Pectoris Accompanied With Diabetes

[Objective] To analyze the Characteristics of Intravascular ultrasound images of patients suffered from angina pectoris accompanied with diabetes mellitus through Intravascular ultrasound(IVUS).[Materials and Methods] 60 IVUS -proving angina pectoris (AP) cases are selected and divided into two groups according to with or without diabetes mellitus . DM group is consist of 23 cases; without diabetes mellitus group is 37. IVUS are applied in all patients with CHD.[Results] 60 lesions are analyzed:1,There are no significant differences in age, sex, smoking and hypertension between the two groups. However, serum concentration of total cholesterol, trilycerid, LDL-C is obviously higher and hdl-c is apparently lower in the diabetes mellitus group than in that of without diabetes mellitus group.2,The occurrence of single vessel disease, two vessel disease and triple vessel disease is 4 (17.4%) ,6 (26.1%) and 13 (56.5%) in the diabetes mellitus group and is 23 (62.2%) ,9 (24.3%) and 5 (13.5%) in the without diabetes mellitus group. those statistics shows that there is a significantly higher incidence of triple vessel disease in the former group( P < 0.001), and patient in the diabetes group also have more complicated coronary lesion and diffuse coronary disease (60.1% vs 13.5%, P < 0.001) than that of patients in without diabetes mellitus group. But the distribution of coronary artery lesions is similar between the diabetes and control group.3. The luminal area (LA ) of DM group is significantly smaller than without diabetes mellitus group, whereas the plaque area (PA) and plaque burden (PB) significantly bigger than without diabetes mellitus group (P< 0.05). The remodeling index of diabetic group is significantly lower than non-diabetic group (P <0.05).4. In the 60 culprit and target lesions, 12 patients (75%) in the DM group and 4 patients (25%) in the without diabetes mellitus group are moderately calcified; there are 11 patients (25%) with non/mild calcification in the DM group while there are 33 patients (75%) in the without diabetes mellitus group. Compared with non-DM group, the proportion of patients with severe calcification is larger in DM group.[Conclusions]1. Patients with diabetes often accompanied with abnormal lipid metablism, so the study suggests that diabetes is a independent risk factor for coronary artery disease.2. Multi-vessel coronary artery disease is significantly higher in DM with CHD group than without diabetes mellitus group, and the disease is severe and diffuse.3. Vascular lesions of CHD patients with DM is mainly negative remodeling, and more common and severe than CHD patients without diabetes mellitus. The LA of CHD with DM patients is significantly smaller than that of the without diabetes mellitus group, while PA and PB in the CHD with DM group are significantly bigger than that of the without diabetes mellitus group. The analysis suggests that coronary atherosclerosis of the former developed rapidly and vessel stenosis was more severe.4. Compared with without diabetes mellitus group, FVUS analysis suggests that the atherosclerotic plaque of patients in DM group is higher calcified, which indicates that calcified plaques may be the important cause of stenosis in cavity and severe negative remodeling. And calcified plaques may be one of the mechanisms of cardiovascular events.