BACKGROUND: Pathologic studies have revealed that coronary arteries undergo compensatory enlargement in the presence of atherosclerosis. METHODS: In order to assess coronary artery remodeling in vivo, we used intravascular ultrasound to examine 46 patients (36 men and 10 women; aged 58.2 +/- 6.8 years) with non-calcified plaques. The vessel, lumen, and plaque areas of the atherosclerotic and of normal proximal and distal segments were determined. RESULTS: A total of 92 atherosclerotic segments were analyzed. The degree of stenosis ranged from 9.2 to 92.8% (mean 34.1 +/- 16.9%) and the plaque area from 2 to 19.6 mm2 (mean 6.3 +/- 3.6 mm2). The vessel area of the atherosclerotic segment (mean 20.4 +/- 7.3 mm2) was larger than that of the proximal segment (mean 18.7 +/- 7.3 mm2, P = 0.018). The vessel area increased in proportion to plaque area. This relationship can be described using the equation y = 23.5(1-e-0.35x). The difference between the vessel area in the atherosclerotic segment and that in the proximal normal segment correlated with the percentage of stenosis (r = 0.53, P < 0.005) until the degree of stenosis exceeded 45%. CONCLUSION: This study indicates that coronary artery remodeling, previously observed in pathologic studies, can be evaluated using intravascular ultrasound in vivo. As a result of the compensatory enlargement of the vessel, coronary angiography cannot be used to detect or exclude the early signs of coronary atherosclerosis.
BACKGROUND: Pathologic studies have revealed that coronary arteries undergo compensatory enlargement in the presence of atherosclerosis. METHODS: In order to assess coronary artery remodeling in vivo, we used intravascular ultrasound to examine 46 patients (36 men and 10 women; aged 58.2 +/- 6.8 years) with non-calcified plaques. The vessel, lumen, and plaque areas of the atherosclerotic and of normal proximal and distal segments were determined. RESULTS: A total of 92 atherosclerotic segments were analyzed. The degree of stenosis ranged from 9.2 to 92.8% (mean 34.1 +/- 16.9%) and the plaque area from 2 to 19.6 mm2 (mean 6.3 +/- 3.6 mm2). The vessel area of the atherosclerotic segment (mean 20.4 +/- 7.3 mm2) was larger than that of the proximal segment (mean 18.7 +/- 7.3 mm2, P = 0.018). The vessel area increased in proportion to plaque area. This relationship can be described using the equation y = 23.5(1-e-0.35x). The difference between the vessel area in the atherosclerotic segment and that in the proximal normal segment correlated with the percentage of stenosis (r = 0.53, P < 0.005) until the degree of stenosis exceeded 45%. CONCLUSION: This study indicates that coronary artery remodeling, previously observed in pathologic studies, can be evaluated using intravascular ultrasound in vivo. As a result of the compensatory enlargement of the vessel, coronary angiography cannot be used to detect or exclude the early signs of coronary atherosclerosis.
Authors: C von Birgelen; W Klinkhart; G S Mintz; H Wieneke; D Baumgart; M Haude; T Bartel; S Sack; J Ge; R Erbel Journal: Heart Date: 2000-11 Impact factor: 5.994
Authors: Cristina T Beneli; Priscila F Barbosa; Elaine M Floriano; Mônica A Abreu; Fernando S Ramalho; Jorge Elias Júnior; Marcos A Rossi; Simone G Ramos Journal: Int J Exp Pathol Date: 2009-06 Impact factor: 1.925
Authors: C von Birgelen; G S Mintz; E A de Vrey; P W Serruys; T Kimura; M Nobuyoshi; J J Popma; M B Leon; R Erbel; P J de Feyter Journal: Heart Date: 2000-02 Impact factor: 5.994
Authors: C Di Mario; C von Birgelen; F Prati; B Soni; W Li; N Bruining; P P de Jaegere; P J de Feyter; P W Serruys; J R Roelandt Journal: Br Heart J Date: 1995-05