Contribution of inadequate compensatory enlargement to development of human coronary artery stenosis: An in vivo intravascular ultrasound study

Nishioka, Toshihiko; Luo, Hao; Eigler, Neal; Berglund, Hans; Kim, Chong Jin; Siegel, Robert J.

doi:10.1016/0735-1097(96)00071-x

Cited by 220 publications

(106 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3,10 In this study, however, we found no relation between remodeling in atherosclerosis and remodeling or late lumen loss after balloon angioplasty. Whether this result is specific for the animal model used in this investigation remains to be determined, although as mentioned previously remodeling in this model seems to parallel remodeling in human coronary arteries closely.…”

Section: Remodeling In De Novo Atherosclerosis and Remodeling After Bcontrasting

confidence: 80%

“…[1][2][3] In contrast to enlargement, shrinkage of an atherosclerotic artery enhances arterial obstruction that is caused by atherosclerotic plaque. 2,3 Remodeling after balloon angioplasty has also been reported and has been recognized as a major determinant of restenosis. After balloon angioplasty, shrinkage seems to be the predominant, although certainly not the only, mode of remodeling.…”

Section: Discussionmentioning

confidence: 99%

“…G eometric remodeling in de novo atherosclerosis [1][2][3][4] and in restenosis after balloon angioplasty [5][6][7][8][9] constitutes a change in total arterial circumference that, together with plaque growth or neointima formation, determines the lumen of the artery. The change in total arterial circumference ranges from enlargement, which may lead to an actual increase in lumen size, to shrinkage.…”

mentioning

confidence: 99%

See 2 more Smart Citations

The Relation Between De Novo Atherosclerosis Remodeling and Angioplasty-Induced Remodeling in an Atherosclerotic Yucatan Micropig Model

Smet

Pasterkamp

Helm

et al. 1998

ATVB

View full text Add to dashboard Cite

Abstract-Geometric remodeling in de novo atherosclerosis and in restenosis after balloon angioplasty constitutes a change in total arterial circumference that, together with plaque growth or neointima formation, determines the lumen of the artery. The heterogeneous nature of arterial obstructions raises the question of whether early and late outcomes (restenosis) of angioplasty are affected by the degree and direction of de novo atherosclerotic remodeling. This study was designed to assess the relationship between atherosclerotic remodeling and the degree and mechanism of restenosis after balloon angioplasty. Atherosclerosis was induced in 27 peripheral arteries of 18 Yucatan micropigs by a combination of denudation and atherogenic diet. Balloon angioplasty was performed, with serial intravascular ultrasound and quantitative angiography before and after intervention and at 42 days' follow-up. We used the relative media-bounded area (MBA), defined as the MBA of the treated site divided by the MBA of the reference, before angioplasty as a measure of remodeling in de novo atherosclerosis and late MBA loss as a measure of remodeling after balloon angioplasty. Relative MBA before angioplasty was not correlated with angiographic and echographic acute gain after balloon angioplasty (rϭ. Key Words: remodeling Ⅲ intravascular ultrasound Ⅲ balloon angioplasty Ⅲ atherosclerosis Ⅲ restenosis G eometric remodeling in de novo atherosclerosis 1-4 and in restenosis after balloon angioplasty 5-9 constitutes a change in total arterial circumference that, together with plaque growth or neointima formation, determines the lumen of the artery. The change in total arterial circumference ranges from enlargement, which may lead to an actual increase in lumen size, to shrinkage. In the latter case, remodeling contributes to luminal (re)narrowing. The different contributions of remodeling and plaque formation to the atherosclerotic process result in a heterogeneity of atherosclerotic arterial obstructions, with a large plaque mass accommodated by a locally enlarged artery at one extreme and a small plaque in a focally shrunken artery at the other. The heterogeneous nature of arterial obstructions with respect to remodeling raises the question of whether early and late outcomes (restenosis) of angioplasty are affected by the degree and direction of de novo atherosclerotic remodeling and whether, for instance, a lesion based predominantly on shrinkage will restenose by remodeling rather than by neointima formation.In a recent serial IVUS study from our laboratory in human femoral arteries, 10 we observed no difference in acute lumen gain between three categories of de novo atherosclerotic remodeling, ie, enlarged, unchanged, and shrunken arteries. However, the mechanism of acute gain by balloon angioplasty was different, showing more plaque reduction or axial redistribution of plaque in enlarged arteries and more stretch of the arterial wall (increase in MBA) in shrunken arteries.Restenosis is the arithmetic sum of neointima formation, [11...

show abstract

Section: Remodeling In De Novo Atherosclerosis and Remodeling After Bcontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

The Relation Between De Novo Atherosclerosis Remodeling and Angioplasty-Induced Remodeling in an Atherosclerotic Yucatan Micropig Model

Smet

Pasterkamp

Helm

et al. 1998

ATVB

View full text Add to dashboard Cite

show abstract

“…8 However, these IVUS studies have also shown that negative remodeling (shrinkage of EEM CSA at the lesion site) is observed in 15% to 34% of stenotic lesions and, along with the plaque accumulation, contributes to luminal narrowing. 9,10 Studies correlating IVUS and clinical findings have suggested that positive remodeling lesions may be more biologically active and negative remodeling lesions more inert.…”

Section: Discussionmentioning

confidence: 99%

Impact of Preinterventional Arterial Remodeling on Neointimal Hyperplasia After Implantation of (Non–Polymer-Encapsulated) Paclitaxel-Coated Stents

Mintz

Tinana

Hong³

et al. 2003

Circulation

View full text Add to dashboard Cite

Background-This study used serial volumetric intravascular ultrasound (IVUS) to evaluate the effect of preinterventional arterial remodeling on in-stent intimal hyperplasia (IH) after implantation of non-polymer-encapsulated paclitaxelcoated stents. Methods and Results-Patients were randomized to placebo or one of two doses of paclitaxel (low dose, 1.28 g/mm 2 ; high dose, 3.10 g/mm 2 ). Complete preinterventional, post-stent implantation, and follow-up IVUS were available in 18 low-dose and 21 high-dose patients. IH volumes were similar in low-dose and high-dose patients: 17.6Ϯ15.1 mm

show abstract

“…[10][11][12][13][14][15][16][17][18] More recently, pathology and IVUS studies have also shown that compensatory enlargement is often inadequate to preserve lumen size completely, and that some vessels may not remodel or, paradoxically, may even shrink at the lesion site. [19][20][21][22][23][24][25][26] Positive remodeling and larger plaques have been associated with acute coronary syndromes. However, information is lacking on the relationship between coronary arterial remodeling and the different types of acute coronary syndromes.…”

Section: Introductionmentioning

confidence: 99%

Coronary arterial remodeling in differing clinical presentations of unstable angina pectoris—an intravascular ultrasound study

Iwami¹,

Nishioka²,

Fishbein³

et al. 2003

Clinical Cardiology

Self Cite

View full text Add to dashboard Cite

Background: Coronary arterial remodeling influences the clinical presentation of ischemic heart disease; however, there is little information on the relationship between coronary arterial remodeling and the type of angina pectoris that patients manifest. Hypothesis: The study was undertaken to determine the difference of coronary arterial remodeling in patients with different types of angina pectoris. Methods: We analyzed 100 patients with ischemic heart disease using intravascular ultrasound (IVUS). Intracoronary IVUS images of proximal reference (PR), distal reference (DR), and target lesion were recorded, and intraluminal area (LA) and external elastic membrane (EEM) were measured. We defined a remodeling index as 100 × (lesion EEM — [PR‐EEM + DR‐EEM]/2) / ([PR‐EEM + DR‐EEM]/2). Cases were classified into three groups according to the clinical history (Group 1a: de novo unstable angina pectoris, Group 1b: accelerating unstable angina pectoris, and Group 2; stable angina pectoris). Results: The remodeling index in Group 1a was significantly larger than that in Groups 1b and 2 (18.6 ±28.5 vs. 5.3 ± 27.1 and 18.6 ± 28.5 vs. —2.7 ± 17.6, p = 0.0347 and p = 0.0005, respectively), but there was no statistical difference in remodeling index between Groups 1b and 2. Conclusions: Our results indicate that positive coronary arterial remodeling is more prevalent in patients with new onset of angina pectoris. The specific type of coronary arterial remodeling may affect the clinical presentation of patients with coronary artery disease.

show abstract

Contribution of inadequate compensatory enlargement to development of human coronary artery stenosis: An in vivo intravascular ultrasound study

Abstract: Compensatory enlargement commonly (54%) occurs at stenotic coronary lesions. However inadequate compensatory enlargement results in a substantial amount (39%) of the lumen area reduction in 26% of primary coronary artery lesions.

Cited by 220 publications

References 13 publications

The Relation Between De Novo Atherosclerosis Remodeling and Angioplasty-Induced Remodeling in an Atherosclerotic Yucatan Micropig Model

The Relation Between De Novo Atherosclerosis Remodeling and Angioplasty-Induced Remodeling in an Atherosclerotic Yucatan Micropig Model

Impact of Preinterventional Arterial Remodeling on Neointimal Hyperplasia After Implantation of (Non–Polymer-Encapsulated) Paclitaxel-Coated Stents

Coronary arterial remodeling in differing clinical presentations of unstable angina pectoris—an intravascular ultrasound study

Contact Info

Product

Resources

About