Angiographic predictors of new coronary occlusions

Pétursson, M. K.; Jonmundsson, E.; Brekkan, A; Harðarson, Þórður

doi:10.1016/0002-8703(95)90279-1

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…17 Vulnerable plaques may not been seen, and a significant number of the episodes of disruption that precipitate infarction occur in coronary arteries that appear normal or only mildly stenotic on the angiogram. 18 Intravascular ultrasonography (IVUS) may be better in demonstrating the presence and extent of atherosclerosis, 19,20 because unlike contrast angiography, which does not predict the likelihood of an intact plaque rupturing, 21,22 IVUS can indicate plaque vulnerability by an echo-lucent zone inside large eccentric plaque. 23 However, as an IVUS study is expensive and time consuming, it is not possible to use it to examine all patients.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Konta

Bett

2003

Circ J

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espite positive changes in lifestyle and the use of new pharmacological approaches to lowering plasma cholesterol concentrations, the frequency of cardiac death and coronary events continues to be high in Western countries. [1][2][3][4] Many coronary risk factors have been identified, principally through population-based methods, but interestingly, fully half of all patients with coronary disease do not have any of the established coronary risk factors (ie, hypertension, hypercholesterolemia, cigarette smoking, diabetes mellitus, marked obesity, and physical inactivity). 4 Further investigation of the cardiac risk factors has suggested links between various mechanical stresses and the site of lesion predilection and rupture. [5][6][7][8][9] Local stresses may result in the induction of endothelial injury with consequent development of atherosclerosis and tearing soft plaque. [10][11][12] The coronary arteries are tethered to the epicardial surface of the heart and must move with each myocardial contraction. Through repeated observation of the motion of the coronary arteries and the location of plaque formation in diseased vessels, we formed the hypothesis that a critical movement pattern of the coronary arteries may result in localized stress points within the vessel and thus the development of atherosclerosis. 5 The purpose of the present study was to analyze the motion of diseased coronary arteries and examine the correlation between these coronary movement patterns and the sites of identified lesions. MethodsUsing 100 consecutive angiograms performed from August 1999 to September 1999 we retrospectively analyzed the coronary artery movement (CAM) as well as the severity of obstruction. Coronary angiography, which was performed because of suspicion of ischemic heart disease, used standard techniques in multiple projections. The severity of obstruction was calculated by measuring with calipers the diameter of the stenotic area in relation to the adjacent normal artery in the view in which the stenosis was most severe.We classified CAM into 10 patterns (Fig 1): (1) bend = coronary artery flexes into a single large curve; (2) multiple bend = coronary artery flexes into 2 or more curves; (3) compression = segmental length is shortened without vertical deviation of the artery (less than one artery diameter); Patterns of Coronary Artery Movement and the Development of Coronary AtherosclerosisTsuyoshi Konta, MD; John Hugh Nicholas Bett, MB, BS Mechanical stress in coronary arteries has been postulated to cause endothelial injury and atherosclerotic lesions, but the relationship between the pattern of coronary artery movement (CAM) and lesion severity is not known. In the present study CAM was classified into 10 patterns, which were grouped into 3 classes: (1) bend type = coronary artery flexes into a curve; (2) compression type = segmental length is shortened without vertical deviation of the artery; (3) displacement type = location of the coronary artery shifts without change of segmental length or shape. Assessmen...

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Section: Discussionmentioning

confidence: 99%

Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Konta

Bett

2003

Circ J

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“…From angiographic studies, it has been demonstrated that critical stenosis progresses to occlusion more often than milder stenosis and non-significant plaques (33,34). There is, however, not necessarily an association between progression and cardiac events.…”

Section: The Open(-ed?) Arterymentioning

confidence: 99%

Appropriateness of Percutaneous Transluminal Coronary Angioplasty in Stable and Unstable Angina Pectoris. A review

Grip

2000

Scandinavian Cardiovascular Journal

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“…17,34]. Selbst der Goldstandard der Stenosediagnostik, die Herzkatheteruntersuchung mit Koronarangiographie, ist nicht geeignet, kardiale Ereignisse verläßlich vorherzusagen [32]. Im Umkehrschluß ist bei asymptomatischen Patienten die Durchführung dieser Tests nicht indiziert (Typ-B-bzw.…”

Section: Pathomechanismusunclassified

Stellenwert der Kalkbestimmung mit Elektronenstrahltomographie bei koronarer Herzkrankheit

et al. 1998

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Coronary calcium is a sensitive marker of coronary artery disease. In the clinical setting EBT is indicated in patients with known coronary artery disease (to evaluate prognosis), in patients who are unable to perform a stress test, and in patients with atypical chest pain. However, lack of calcification may be associated with severe stenoses in a minority of patients. The clinical value in asymptomatic patients needs to be defined: randomized studies are necessary. We see a possible indication in patients with known risk factors, in whom primary preventive strategies could be performed more selectively and cost-effectively.

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Angiographic predictors of new coronary occlusions

Cited by 9 publications

References 27 publications

Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Patterns of Coronary Artery Movement and the Development of Coronary Atherosclerosis

Appropriateness of Percutaneous Transluminal Coronary Angioplasty in Stable and Unstable Angina Pectoris. A review

Stellenwert der Kalkbestimmung mit Elektronenstrahltomographie bei koronarer Herzkrankheit

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