In vivo validation of compensatory enlargement of atherosclerotic coronary arteries

James B. Hermiller, Alan N. Tenaglia, Katherine B. Kisslo, Harry R. Phillips, Thomas M. Bashore, Richard S. Stack, Charles J. Davidson

Research output: Contribution to journalArticle

203 Citations (Scopus)

Abstract

Necropsy examinations and epicardial ultrasound studies have suggested that atherosclerotic coronary arteries undergo compensatory enlargement. This increase in vessel size may be an important mechanism for maintaining myocardial blood flow. It also is of fundamental importance in the angiographic study of coronary disease progression and regression. The purpose of this study was to determine, using intracoronary ultrasound, whether coronary arteries undergo adaptive expansion in vivo. Forty-four consecutive patients were studied (30 men, 14 women; mean age 56 ± 10 years). Eighty intravascular ultrasound images were analyzed (32 left main, 23 left anterior descending and 25 right coronary arteries). Internal elastic lamina area, a measure of overall vessel size increased as plaque area expanded (r = 0.57, p = 0.0001, SEE = 5.5 mm2). When the left main, left anterior descending and right coronary arteries were examined individually, there continued to be as great or greater positive correlation between internal elastic lamina and plaque area (left anterior descending: r = 0.75, p = 0.0001; right coronary arteries: r = 0.63, p = 0.0007; left main: r = 0.56, p = 0.0009), implying that each of the vessels and all in aggregate underwent adaptive enlargement. When only those vessels with <30% area stenosis were examined, internal elastic lamina correlated well with plaque area (r = 0.79, and p = 0.0001), and for each 1 mm2 increase in plaque area, internal elastic lamina increased 2.7 mm2. This suggests that arterial enlargement may overcompensate for early atherosclerotic lesions. As a result, there was no relation between percent area stenosis and lumen area for <30% stenosis, but with greater stenoses, lumen area significantly declined. These human in vivo results validate the hypothesis that individual coronary arteries undergo adaptive enlargement that maintains or augments lumen area during the early stages of atherosclerosis.

Original languageEnglish
Pages (from-to)665-668
Number of pages4
JournalThe American journal of cardiology
Volume71
Issue number8
DOIs
StatePublished - Mar 15 1993
Externally publishedYes

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Coronary Vessels
Pathologic Constriction
Coronary Disease
Disease Progression
Atherosclerosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hermiller, J. B., Tenaglia, A. N., Kisslo, K. B., Phillips, H. R., Bashore, T. M., Stack, R. S., & Davidson, C. J. (1993). In vivo validation of compensatory enlargement of atherosclerotic coronary arteries. The American journal of cardiology, 71(8), 665-668. https://doi.org/10.1016/0002-9149(93)91007-5

In vivo validation of compensatory enlargement of atherosclerotic coronary arteries. / Hermiller, James B.; Tenaglia, Alan N.; Kisslo, Katherine B.; Phillips, Harry R.; Bashore, Thomas M.; Stack, Richard S.; Davidson, Charles J.

In: The American journal of cardiology, Vol. 71, No. 8, 15.03.1993, p. 665-668.

Research output: Contribution to journalArticle

Hermiller, JB, Tenaglia, AN, Kisslo, KB, Phillips, HR, Bashore, TM, Stack, RS & Davidson, CJ 1993, 'In vivo validation of compensatory enlargement of atherosclerotic coronary arteries', The American journal of cardiology, vol. 71, no. 8, pp. 665-668. https://doi.org/10.1016/0002-9149(93)91007-5
Hermiller JB, Tenaglia AN, Kisslo KB, Phillips HR, Bashore TM, Stack RS et al. In vivo validation of compensatory enlargement of atherosclerotic coronary arteries. The American journal of cardiology. 1993 Mar 15;71(8):665-668. https://doi.org/10.1016/0002-9149(93)91007-5
Hermiller, James B. ; Tenaglia, Alan N. ; Kisslo, Katherine B. ; Phillips, Harry R. ; Bashore, Thomas M. ; Stack, Richard S. ; Davidson, Charles J. / In vivo validation of compensatory enlargement of atherosclerotic coronary arteries. In: The American journal of cardiology. 1993 ; Vol. 71, No. 8. pp. 665-668.
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