Document Detail

Effect of atherosclerotic regression on total luminal size of coronary arteries as determined by intravascular ultrasound.
MedLine Citation:
PMID:  16784914     Owner:  NLM     Status:  MEDLINE    
We assessed vascular changes during atherosclerosis regression. Compensatory enlargement of coronary arteries accommodates plaque burden during atherosclerosis development. Lipid-lowering therapy has altered the natural history of coronary atherosclerosis, but the arterial changes that occur during disease regression need to be clarified. Intravascular ultrasound was performed at baseline and after approximately 18 months in 432 patients with coronary disease. Mean plaque, lumen, and total vessel area were computed in a 30-mm coronary segment of interest. Mean low-density lipoprotein cholesterol level was 2.4 mmol/L, and 88% of patients received statins. Overall, changes in plaque and total vessel areas were highly correlated (r = 0.82, p <0.0001). Among the 227 patients with plaque regression, the plaque area decrease was -0.58 +/- 0.54 mm(2), and changes in total vessel and lumen areas were -1.02 +/- 1.10 and -0.44 +/- 0.86 mm(2), respectively. The decrease in plaque area correlated better with the change in total vessel area (r = 0.64, p <0.0001) than with the change in lumen area (r = 0.20, p = 0.003). The relation between plaque regression and decrease in total vessel area was significantly better (p = 0.019) for patients with a >40% atheroma area (r = 0.72; p <0.0001) than for those with <or=40% (r = 0.48; p = 0.0004). In conclusion, regression of atherosclerotic plaque is generally accompanied by a decrease in total vessel size, without an increase in luminal dimensions. This reverse vascular remodeling may be responsible for the "regression paradox," whereby secondary prevention is associated with clinical benefits despite minimal improvement in coronary lumen dimensions.
Jean-Claude Tardif; Jean Grégoire; Philippe L L'Allier; Reda Ibrahim; Marc-André Lavoie; Michel LeMay; Eric Cohen; Sylvie Levesque; Pierre-Frédéric Keller; Therese Heinonen; Marie-Claude Guertin
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Publication Detail:
Type:  Journal Article     Date:  2006-05-03
Journal Detail:
Title:  The American journal of cardiology     Volume:  98     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-20     Completed Date:  2006-08-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  23-7     Citation Subset:  AIM; IM    
Department of Medicine and Research Center of the Montreal Heart Institute, Université de Montreal, Montreal, Quebec, Canada.
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MeSH Terms
Acetates / therapeutic use
Cholesterol, LDL / blood
Coronary Artery Disease / drug therapy,  pathology,  ultrasonography*
Coronary Vessels / pathology,  ultrasonography*
Disease Progression
Follow-Up Studies
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Image Processing, Computer-Assisted
Middle Aged
Regression Analysis
Sulfonic Acids / therapeutic use
Total Lung Capacity / physiology
Ultrasonography, Interventional / methods*
Reg. No./Substance:
0/Acetates; 0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Sulfonic Acids; 166518-60-1/avasimibe

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