Document Detail


Contribution of inadequate arterial remodeling to the development of focal coronary artery stenoses. An intravascular ultrasound study.
MedLine Citation:
PMID:  9107165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Adaptive remodeling occurs to compensate for the accumulation of atherosclerotic plaque. Lumen reduction depends on the relative rates of plaque deposition and adaptive remodeling responses. Intravascular ultrasound permits detailed, high-quality, cross-sectional imaging of the coronary arteries in vivo. METHODS AND RESULTS: Preintervention intravascular ultrasound was used to study 603 focal, new, nonostial significant coronary artery stenoses in patients with chronic stable angina. Measurements of the target lesion of the external elastic membrane (EEM), lumen, and plaque plus media (P&M; P&M = EEM - Lumen) cross-sectional areas (CSAs) were compared with a proximal reference segment (most normal-looking cross section within 10 mm proximal to the lesion but distal to any side branch). Inadequate remodeling was defined as lesion/ reference EEM CSA that exceeded the upper limits of normal arterial tapering (lesion/reference EEM CSA ratio < or = 0.78 or a 21% reduction in EEM CSA per 10-mm length). Overall, the lesion/reference EEM CSA ratio was 1.00 +/- 0.22; 15% of lesions had inadequate remodeling, and 37% of the 603 lesions had less plaque than expected. This represented a lesion-specific response. The only predictor of inadequate remodeling was the arc of superficial lesion calcium. CONCLUSIONS: Inadequate remodeling is present in at least 15% of chronic, focal, new coronary arterial stenoses in patients with stable angina. The magnitude of arterial remodeling appears to be a lesion-specific response.
Authors:
G S Mintz; K M Kent; A D Pichard; L F Satler; J J Popma; M B Leon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  95     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-05-13     Completed Date:  1997-05-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1791-8     Citation Subset:  AIM; IM    
Affiliation:
Intravascular Ultrasound Imaging and Cardiac Catheterization Laboratories, Washington Hospital Center, DC 20010, USA.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological*
Aged
Angina Pectoris / etiology
Arteriosclerosis / complications,  epidemiology,  physiopathology*,  radiography,  ultrasonography
Calcinosis / etiology,  ultrasonography
Cineangiography
Coronary Angiography
Coronary Disease / etiology,  physiopathology*,  radiography,  ultrasonography
Female
Heart Catheterization
Humans
Male
Middle Aged
Nitroglycerin / administration & dosage
Risk Factors
Chemical
Reg. No./Substance:
55-63-0/Nitroglycerin
Comments/Corrections
Comment In:
Circulation. 1998 Apr 14;97(14):1424-5   [PMID:  9577957 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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