Document Detail


The influence of plaque orientation (pericardial or myocardial) on coronary arterial remodeling.
MedLine Citation:
PMID:  11137098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Many systemic, regional and lesion factors have been identified which may influence arterial remodeling, but little is known about the importance of extravascular resistance to vessel enlargement. As myocardial systolic splinting may significantly affect vessel expansion the effect of plaque orientation on arterial remodeling in eccentric coronary atherosclerotic lesions was examined. METHODS: Using intravascular ultrasound imaging to obtain cross-sectional vessel area (VA), plaque area (PA) and lumen area (LA), remodeling in eccentric left anterior descending coronary artery lesions was compared which predominantly involved the pericardial or free arc (P, n=25) and the myocardial side (M, n=40) of the vessel wall. Normalized vessel area (NVA, VA(lesion)/VA(reference)) was compared as a continuous and categorical variable (positive>1.05, intermediate 0.95-1.05, negative<0.95) as well as remodeling index (RI, VA(lesion)-VA(reference)/PA(lesion)-PA(reference)). RESULTS: The two groups were well matched for clinical and lesion characteristics known to affect remodeling. Reference segments areas were similar in the two groups; while lesion LA was also similar, in the pericardial group there was significantly greater lesion PA (P 12.78+/-0.72, M 10.26+/-0.50 mm(2), P<0.05) and VA (P 15.71+/-0.90, M 12.82+/-0.57 mm(2), P<0.05) demonstrating enhanced compensatory remodeling. Outward remodeling was significantly greater in P than in M by both NVA (P 1.03+/-0.03, M 0.86+/-0.03, P<0.01) and RI (P 0.02+/-0.07, M -1.10+/-0.32, P<0.01). Positive, intermediate and negative remodeling occurred in nine, nine and seven lesions in P and in four, ten and 26 lesions in M (P<0.01). CONCLUSIONS: Remodeling compensates more for plaque growth in eccentric coronary lesions which are surrounded by the pericardium than those surrounded by the myocardium. Extravascular resistance appears to influence arterial remodeling.
Authors:
M R Ward; A Jeremias; K Hibi; N A Herity; S T Lo; S D Filardo; D P Lee; P J Fitzgerald; A C Yeung
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Atherosclerosis     Volume:  154     ISSN:  0021-9150     ISO Abbreviation:  Atherosclerosis     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-01-16     Completed Date:  2001-03-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  179-83     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305-5218, USA. mrward@stanford.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Disease / physiopathology*,  ultrasonography*
Coronary Vessels / physiopathology*,  ultrasonography*
Female
Humans
Male
Middle Aged
Ultrasonography, Interventional

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


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