Compensatory enlargement of human coronary arteries identified by magnetic resonance imaging

Abstract

The aim of the present study was to evaluate the role of magnetic resonance imaging (MRI) for the non-invasive detection of coronary abnormalities and specifically the remodeling process in patients with coronary artery disease (CAD). MRI was performed in 10 control healthy subjects and 26 patients with angiographically proven CAD of the right coronary (RCA) or left anterior descending (LAD) artery; 23 patients were within two months of acute coronary syndromes, and 3 had stable angina with a positive test for ischemia. Wall thickness (WT), vessel wall area (VWA), total vessel area (TVA), and luminal area (LA) were measured. There were significant increases in WT (mean ± SEM, RCA: 2.62 ± 0.75 vs 0.53 ± 0.15 mm; LAD: 2.21 ± 0.69 vs 0.62 ± 0.24 mm) and in VWA (RCA: 30.96 ± 17.57 vs 2.1 ± 1.2 mm 2 ; LAD: 19.53 ± 7.25 vs 3.6 ± 2.0 mm 2 ) patients compared to controls (P < 0.001 for each variable). TVA values were also greater in patients compared to controls (RCA: 44.56 ± 21.87 vs 12.3 ± 4.2 mm 2 ; LAD: 31.89 ± 11.31 vs 17.0 ± 6.2 mm 2 ; P < 0.001). In contrast, the LA did not differ between patients and controls for RCA or LAD. When the LA was adjusted for vessel size using the LA/TVA ratio, a significant difference was found: 0.33 ± 0.16 in patients vs 0.82 ± 0.09 in controls (RCA) and 0.38 ± 0.13 vs 0.78 ± 0.06 (LAD) (P < 0.001). As opposed to normal controls, positive remodeling was present in all patients with CAD, as indicated by larger VWA. We conclude that MRI detected vessel wall abnormalities and was an effective tool for the noninvasive evaluation of the atherosclerotic process and coronary vessel wall modifications, including positive remodeling that frequently occurs in patients with acute coronary syndromes.

Impact of high-fat diet on antioxidant status, vascular wall thickening and cardiac function in adult female LDLR&lt;sup&gt;–/–&lt;/sup&gt; mice

“…Interestingly, a thickening of vascular walls was observed but the internal diameter of vessels was preserved in HFD-fed LDLR -/-mice while external diameter was increased. Several studies have reported similar results regarding the enlargement of vessel in plaque sites using magnetic resonance or intravascular ultrasound imaging [34,35]. This enlargement is described as a compensatory response for intimal hyperplasia formation that may lead to vascular expansive remodeling [36].…”

Noninvasive Detection of Coronary Artery Disease - Challenges for Prevention of Disease and Clinical Events

“…[100][101][102][103] We have already detected by magnetic resonance imaging coronary vessel wall modifications, e.g., increases in wall thickness, vessel wall area, and total vessel area in patients with coronary artery disease compared to normal controls. 104 Interestingly, the luminal area was preserved in these patients in spite of the presence of large plaque volumes (Figure 2). Thus, magnetic resonance imaging to determine the luminal area/total vessel area ratio is a noninvasive method for detecting coronary vessel wall modifications including remodeling and for clearly differentiating patients with coronary artery disease from healthy subjects despite a similar lumen (Figures 3a, 3b).…”

“…Magnetic resonance of coronary arteries. Positive remodeling of coronary arteries indicated by increased wall thickness, wall area, and total vessel area with preservation of luminal area104 …”

“…Magnetic resonance of coronary arteries. Observe the increment of wall thickness and total vessel diameter of diseased vessel, a positive remodeling (right) compared to the control (left)104 …”