Objectives The authors performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database. Background Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardial coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported. Methods OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS). Results Among 534 plaques identified in 393 coronary arteries, 27.0% were fibrous plaques, 13.3% were fibrocalcific plaques, 40.8% were thick-cap fibroatheromas, and 18.9% were TCFAs. TCFAs showed clustering in the proximal segment, particularly in the left anterior descending artery. On the other hand, fibrous plaques were relatively evenly distributed throughout the entire length of the coronary arteries. In patients with acute coronary syndromes (ACS), TCFAs showed stronger proximal clustering in the left anterior descending, 2 clustering peaks in the right coronary artery, and 1 clustering peak in the circumflex artery. The pattern of TCFA distribution was less obvious in patients without ACS. The prevalence of TCFA was higher in the highest %AS tertile, compared with the lowest %AS tertile (30% vs. 9%; p < 0.001). Conclusions The present 3-vessel OCT study showed that TCFAs cluster at specific locations in the epicardial coronary arteries, especially in patients with ACS. TCFA was more prevalent in segments with tight stenosis. (The Massachusetts General Hospital Optical Coherence Tomography Registry; [NCT01110538][1]) [1]: https://clinicaltrials.gov/ct2/show/NCT01110538?term=NCT01110538&draw=2&rank=1

中文翻译：

---

易损斑块的空间分布：综合体内冠状斑块映射。

目标作者对我们的 3 血管光学相干断层扫描 (OCT) 数据库中具有不同表型的冠状动脉斑块的分布进行了综合分析。背景 先前的病理学研究表明薄帽纤维粥样硬化 (TCFA) 位于心外膜冠状动脉的特定节段。各种表型的体内冠状动脉斑块的详细描述尚未见报道。方法 每 1 mm 对 131 名患者的所有 3 条冠状动脉的 OCT 图像进行分析，以评估斑块表型和易损性特征。此外，根据狭窄面积百分比 (%AS) 将斑块分成三等分。结果 在 393 条冠状动脉中鉴定出的 534 个斑块中，27.0% 为纤维斑块，13.3% 为纤维钙化斑块，40.8% 为厚帽纤维粥样硬化斑块，18.9% 为 TCFAs。TCFAs 在近端部分呈簇状，特别是在左前降支。另一方面，纤维斑块相对均匀地分布在整个冠状动脉长度上。在急性冠脉综合征（ACS）患者中，TCFAs 在左前降支中表现出更强的近端聚集，在右冠状动脉中有 2 个聚集峰，在回旋支有 1 个聚集峰。在没有 ACS 的患者中，TCFA 的分布模式不太明显。与最低的 %AS 三分位数相比，最高 %AS 三分位数中 TCFA 的流行率更高（30% 对 9%；p < 0.001）。结论 目前的 3 支血管 OCT 研究表明，TCFAs 聚集在心外膜冠状动脉的特定位置，尤其是在 ACS 患者中。TCFA 在狭窄狭窄的节段中更为普遍。（马萨诸塞州总医院光学相干断层扫描登记处；[NCT01110538][1]）[1]：https://clinicaltrials.gov/ct2/show/NCT01110538?term=NCT01110538&draw=2&rank=1