Document Detail

Influence of differential vascular remodeling on the coronary vasomotor response.
MedLine Citation:
PMID:  12909335     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Arterial remodeling may increase or decrease the luminal encroachment of atherosclerotic plaques in the coronary circulation. However, the factors determining the nature and consequences of the remodeling process remain poorly characterized. The study aims were to assess whether the pattern of vascular remodeling influences the physical and vasomotor responses of the coronary arteries in vivo in man. METHODS: Coronary vessel area, distensibility and stiffness were determined in positively, negatively and non-remodeled arterial segments using intravascular ultrasound and Doppler flow measurement. Epicardial vasomotor responses were determined following intracoronary boluses of acetylcholine (10(-6) and 10(-4) M), adenosine (24-30 microg) and nitroglycerin (200 microg). RESULTS: Fifty-six coronary arterial segments were studied in 25 patients. In comparison to non- and positively remodeled segments, negatively remodeled segments had a higher stiffness index (67+/-16 vs. 33+/-5 and 38+/-8, respectively; P<0.02) and appeared to have lower compliance and distensibility (0.66+/-0.17 vs. 1.65+/-0.54 and 0.94+/-0.18/mmHg; P=NS). Non-remodeled segments had a greater change in vessel area with 10(-6) M acetylcholine (4.9+/-0.8%), compared to positively and negatively remodeled segments (0.6+/-1.8% and -4.9+/-1.8%, respectively, P<0.05). A significant degree of preservation of vasodilatation to 10(-6) M acetylcholine was evident in positively remodeled compared with negatively remodeled segments (P<0.05). Nitroglycerin caused greater vasodilatation in non-remodeled segments (7.2+/-3.8%) than either positively or negatively remodeled segments (4.7+/-0.9 and 3.7+/-0.6%, respectively, P<0.05). CONCLUSIONS: Vascular remodeling is an important and major determinant of local epicardial vasomotor responses. Both structural and functional abnormalities are associated with negative remodeling that may contribute to the adverse effects of such lesions.
Andrew L McLeod; David E Newby; David B Northridge; Keith A A Fox; Neal G Uren
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiovascular research     Volume:  59     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-11     Completed Date:  2004-01-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  520-6     Citation Subset:  IM    
Department of Cardiology, Royal infirmary, 51 Little France Crescent, Little France, Edinburgh EH16 4SA, UK.
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MeSH Terms
Acetylcholine / diagnostic use
Adenosine / diagnostic use
Analysis of Variance
Coronary Angiography
Coronary Disease / pathology*,  physiopathology,  ultrasonography
Coronary Vessels / pathology*,  ultrasonography
Endothelium, Vascular / pathology*,  physiopathology,  ultrasonography
Middle Aged
Nitroglycerin / diagnostic use
Ultrasonography, Doppler
Ultrasonography, Interventional
Vasodilator Agents / diagnostic use
Reg. No./Substance:
0/Vasodilator Agents; 51-84-3/Acetylcholine; 55-63-0/Nitroglycerin; 58-61-7/Adenosine

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