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Korean J Obes 2012; 21(3): 148-157

Published online September 30, 2012

Copyright © Korean Society for the Study of Obesity.

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

Soo Hyun Cho, Wang-Soo Lee(1), Sang-Wook Kim(1)*

Department of Family Medicine, Heart Center, Cardiovascular Core Lab(1), College of Medicine, Chung-Ang University Hospit

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 ≥ 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 ± 4.77mm2, 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 (β = 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.

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

Fig. 1.

The correlation between BMI and average LMCA EEM area.

BMI, Body Mass Index; LMCA, Left Main Coronary Artery; EEM, external elastic membrane.

R = 0.149, P = 0.038.

*R = 0.148, *P = 0.040, *partial correlation coefficient adjusted by age.



Baseline characteristics of patients in normal weight, overweight and obesity groups



Quantitative angiographic measurements of left main coronary artery in normal weight, overweight and obesity groups



Intravascular ultrasound measurements of left main coronary artery by in normal weight, overweight and obesity groups



Correlations between Average EEM area of left main coronary artery and various parameters



Associations of Average EEM area of left main coronary artery with various parameters by multiple linear regression analysis


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