BACKGROUND: Although arterial remodeling in atherosclerotic arteries affects luminal patency, the role of plaque components has not been systematically studied. METHODS AND RESULTS: Coronary segments (n=2885) were harvested from the hearts of 36 patients who died of severe coronary artery disease after perfusion fixation. Remodeling was determined by morphometric analysis of 657 sections selected as reference segments and 1318 segments with atheromatous plaques. Atherosclerotic plaques were identified as fibroatheroma, thin-cap fibroatheroma, intraplaque hemorrhage with or without rupture or erosion, or total occlusion. Plaque components consisted of calcification, lipid core, macrophage burden, and fibrosis. There was no correlation between plaque area and lumen size in proximal arteries, unlike middle and distal segments, which demonstrated a significant correlation. Marked expansion of the internal elastic lamina (IEL) occurred in plaque hemorrhages with or without and thin-cap fibroatheroma (vulnerable plaque), whereas in erosions and total occlusions there was shrinkage of the IEL. Macrophage burden, lipid core size, calcium (in fibrous plaque and lipid core), and medial atrophy were all associated with positive remodeling; fibrous areas, however, were negatively associated with remodeling. CONCLUSIONS: Inflammation, calcification, and medial thinning are primary determinants of positive remodeling, which appears to be a feature of plaque instability.
BACKGROUND: Although arterial remodeling in atherosclerotic arteries affects luminal patency, the role of plaque components has not been systematically studied. METHODS AND RESULTS: Coronary segments (n=2885) were harvested from the hearts of 36 patients who died of severe coronary artery disease after perfusion fixation. Remodeling was determined by morphometric analysis of 657 sections selected as reference segments and 1318 segments with atheromatous plaques. Atherosclerotic plaques were identified as fibroatheroma, thin-cap fibroatheroma, intraplaque hemorrhage with or without rupture or erosion, or total occlusion. Plaque components consisted of calcification, lipid core, macrophage burden, and fibrosis. There was no correlation between plaque area and lumen size in proximal arteries, unlike middle and distal segments, which demonstrated a significant correlation. Marked expansion of the internal elastic lamina (IEL) occurred in plaque hemorrhages with or without and thin-cap fibroatheroma (vulnerable plaque), whereas in erosions and total occlusions there was shrinkage of the IEL. Macrophage burden, lipid core size, calcium (in fibrous plaque and lipid core), and medial atrophy were all associated with positive remodeling; fibrous areas, however, were negatively associated with remodeling. CONCLUSIONS: Inflammation, calcification, and medial thinning are primary determinants of positive remodeling, which appears to be a feature of plaque instability.
Authors: Michiel A de Graaf; Joella E van Velzen; Fleur R de Graaf; Joanne D Schuijf; Jouke Dijkstra; Jeroen J Bax; Johan H C Reiber; Martin J Schalij; Ernst E van der Wall; J Wouter Jukema Journal: Heart Vessels Date: 2012-02-18 Impact factor: 2.037
Authors: Carl J Pepine; Keith C Ferdinand; Leslee J Shaw; Kelly Ann Light-McGroary; Rashmee U Shah; Martha Gulati; Claire Duvernoy; Mary Norine Walsh; C Noel Bairey Merz Journal: J Am Coll Cardiol Date: 2015-10-27 Impact factor: 24.094
Authors: Markella V Zanni; Suhny Abbara; Janet Lo; Bryan Wai; David Hark; Eleni Marmarelis; Steven K Grinspoon Journal: AIDS Date: 2013-05-15 Impact factor: 4.177
Authors: Rebecca M Kappus; Christopher A Fahs; Denise Smith; Gavin P Horn; Stomatis Agiovlasitis; Lindy Rossow; Sae Y Jae; Kevin S Heffernan; Bo Fernhall Journal: Am J Hypertens Date: 2013-09-18 Impact factor: 2.689