Relationship between arterial remodelling and serial changes in coronary atherosclerosis by intravascular ultrasound: an analysis of the IBIS-4 study.

Koskinas, Konstantinos C; Maldonado, Rafaela; Garcia-Garcia, Hector M; Yamaji, Kyohei; Taniwaki, Masanori; Ueki, Yasushi; Otsuka, Tatsuhiko; Zanchin, Christian; Karagiannis, Alexios; Radu Juul Jensen, Maria D; Losdat, Sylvain; Zaugg, Serge; Windecker, Stephan; Räber, Lorenz (2021). Relationship between arterial remodelling and serial changes in coronary atherosclerosis by intravascular ultrasound: an analysis of the IBIS-4 study. European heart journal - cardiovascular imaging, 22(9), pp. 1054-1062. Oxford University Press 10.1093/ehjci/jeaa221

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Arterial remodelling is an important determinant of coronary atherosclerosis. Assessment of the remodelling index, comparing a lesion to a local reference site, is a suboptimal correlate of serial vascular changes. We assessed a novel approach which, unlike the local-reference approach, uses the entire artery's global remodelling as reference.


Serial (baseline and 13 months) intravascular ultrasound was performed in 146 non-infarct-related arteries of 82 patients treated with high-intensity statin. Arteries were divided into 3-mm segments (n = 1479), and focal remodelling was characterized in individual segments at both timepoints applying the global arterial reference approach. First, we compared preceding vascular changes in relation to follow-up remodelling. Second, we examined whether baseline remodelling predicts subsequent plaque progression/regression. At follow-up, segments with constrictive vs. compensatory or expansive remodelling had greater preceding reduction of vessel area (-0.67 vs. -0.38 vs. -0.002 mm2; P < 0.001) and lumen area (-0.82 vs. -0.09 vs. 0.40 mm2; P < 0.001). Overall, we found significant regression in percent atheroma volume (PAV) [-0.80% (-1.41 to -0.19)]. Segments with constrictive remodelling at baseline had greater subsequent PAV regression vs. modest regression in the compensatory, and PAV progression in the expansive remodelling group (-6.14% vs. -0.71% vs. 2.26%; P < 0.001). Lesion-level analyses (n = 118) showed no differences when remodelling was defined by the local reference approach at baseline or follow-up.


Remodelling assessment using a global arterial reference approach, but not the commonly used, local reference site approach, correlated reasonably well with serial changes in arterial dimensions and identified arterial segments with subsequent PAV progression despite intensive statin treatment and overall atheroma regression.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR)

UniBE Contributor:

Koskinas, Konstantinos, Ueki, Yasushi, Otsuka, Tatsuhiko, Zanchin, Christian, Karagiannis Voules, Alexios, Losdat, Sylvain Pierre, Windecker, Stephan, Räber, Lorenz


600 Technology > 610 Medicine & health




Oxford University Press




Andrea Flükiger-Flückiger

Date Deposited:

24 Sep 2020 16:07

Last Modified:

20 Feb 2024 14:16

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

atherosclerosis intravascular ultrasound plaque regression remodelling




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