Title of article :
Effect of Atherosclerotic Regression on Total Luminal Size of Coronary Arteries as Determined by Intravascular Ultrasound
Author/Authors :
Tardif، نويسنده , , Jean-Claude and Grégoire، نويسنده , , Jean and LʹAllier، نويسنده , , Philippe L. and Ibrahim، نويسنده , , Reda and Lavoie، نويسنده , , Marc-André and LeMay، نويسنده , , Michel and Cohen، نويسنده , , Eric and Levesque، نويسنده , , Sylvie and Keller، نويسنده , , Pierre-Frédéric and Heinonen، نويسنده , , Therese and Guertin، نويسنده , , Marie-Claude، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2006
Pages :
5
From page :
23
To page :
27
Abstract :
We assessed vascular changes during atherosclerosis regression. Compensatory enlargement of coronary arteries accommodates plaque burden during atherosclerosis development. Lipid-lowering therapy has altered the natural history of coronary atherosclerosis, but the arterial changes that occur during disease regression need to be clarified. Intravascular ultrasound was performed at baseline and after ∼18 months in 432 patients with coronary disease. Mean plaque, lumen, and total vessel area were computed in a 30-mm coronary segment of interest. Mean low-density lipoprotein cholesterol level was 2.4 mmol/L, and 88% of patients received statins. Overall, changes in plaque and total vessel areas were highly correlated (r = 0.82, p <0.0001). Among the 227 patients with plaque regression, the plaque area decrease was −0.58 ± 0.54 mm2, and changes in total vessel and lumen areas were −1.02 ± 1.10 and −0.44 ± 0.86 mm2, respectively. The decrease in plaque area correlated better with the change in total vessel area (r = 0.64, p <0.0001) than with the change in lumen area (r = 0.20, p = 0.003). The relation between plaque regression and decrease in total vessel area was significantly better (p = 0.019) for patients with a >40% atheroma area (r = 0.72; p <0.0001) than for those with ≤40% (r = 0.48; p = 0.0004). In conclusion, regression of atherosclerotic plaque is generally accompanied by a decrease in total vessel size, without an increase in luminal dimensions. This reverse vascular remodeling may be responsible for the “regression paradox,” whereby secondary prevention is associated with clinical benefits despite minimal improvement in coronary lumen dimensions.
Journal title :
American Journal of Cardiology
Serial Year :
2006
Journal title :
American Journal of Cardiology
Record number :
1901056
Link To Document :
بازگشت