Abstract 4144239: The Relationship Between Endothelial Function and Tissue Characterization After Drug-coated Balloon for De-novo Coronary Lesion

Background: The previous our study showed that vasomotion may be better preserved after drug-coated balloon (DCB) treatment than after stenting. However, there is no information available on the relationship between endothelial function and tissue characterization after DCB treatment. Aims: The purpose of this study was to investigate the relationship between endothelial function and tissue characterization after DCB for de-novo coronary lesion. Methods: We prospectively studied 19 patients who underwent acetylcholine provocation test and intravascular imaging at 8-month after DCB treatment. To evaluate endothelial-dependent vasomotion, the mean lumen diameter of the distal segment, beginning 5 mm and ending 15 mm distal to the edge of the treated segment, was quantitatively measured by angiography during the acetylcholine provocation test. Tissue characterization was assessed with integrated backscatter intravascular ultrasound (IB-IVUS). Results: There was a positive correlation between endothelial-dependent vasomotion and the proportion of lipid plaque in treated segments (r 2 =0.610, p=0.009). On the other hand, there were negative correlations between endothelial-dependent vasomotion and the proportion of dense fibrous or calcified plaque in treated segments (r 2 =-0.709, p=0.001, r 2 =-0.773, p<0.001). Conclusion: Endothelial-dependent vasomotion was better preserved in lipid-rich lesions than in dense fibrous or calcified lesions, suggesting that endothelial function could be more impaired in lesions with advanced atherosclerosis after DCB treatment.