Korean J Obes.  2012 Sep;21(3):148-157. 10.7570/kjo.2012.21.3.148.

The Relationship Between Body Mass Index and Left Main Coronary Artery Architecture: A Virtual Histology Intravascular Ultrasound Analysis

Affiliations
  • 1Department of Family Medicine, College of Medicine, Chung-Ang University Hospital, Korea.
  • 2Heart Center, Cardiovascular Core Lab, College of Medicine, Chung-Ang University Hospital, Korea. swivus@gmail.com

Abstract

BACKGROUND
An obesity paradox exists in which the overweight and obese patients seem to have a more favorable prognosis than in leaner patients with cardiovascular diseases. We evaluated the relationship between Body mass index (BMI) and Left Main Coronary Artery (LMCA) by Virtual Histology Intravascular Ultrasound (VH-IVUS).
METHODS
We analyzed data from 195 patients with coronary artery disease who were enrolled in the Heart Center. We measured the vascular structure of LMCA with VH-IVUS undergoing intervention.
RESULTS
Mean age of healthy weight group (BMI < 23.0 mg/m2), overweight group (BMI, 23.0-24.9 mg/m2) and obese group (BMI > or = 25.0 mg/m2) were 64.88 +/- 10.73, 59.63 +/- 14.22, 59.07 +/- 10.66 years old, respectively. The mean age of healthy weight group was significantly older (P = 0.009). Mean values of lesion length, minimal lumen diameter, % diameter stenosis were not significant (P > 0.05). Mean values of EEM (External Elastic Membrane) area of obese group was statistically larger than that of the healthy weight group (26.26 +/- 4.82 mm2, 24.16 +/- 4.77 mm2, respectively)(P = 0.030). However, lumen area, plaque area, plaque burden, etc. were similar (P > 0.05). EEM area had a positive correlation with BMI (R = 0.149; P = 0.038). According to the multiple linear models, weight was the best predictor of LMCA EEM area (beta = 0.067; P = 0.047).
CONCLUSION
LMCA of obese group was larger than that of healthy weight group. The clinical impact of larger LMCA deserve further study.

Keyword

Obesity paradox; Body mass index (BMI); Left main coronary artery; Virtual Histology Intravascular ultrasound (VH-IVUS); Coronary artery diseases

MeSH Terms

Body Mass Index
Cardiovascular Diseases
Constriction, Pathologic
Coronary Artery Disease
Coronary Vessels
Heart
Humans
Linear Models
Obesity
Overweight
Prognosis
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