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Clin. Cardiol. 24, 443450 (2001)
Kikuo Isoda, M.D., Koh Arakawa, M.D., Yashuhiro Kamezawa, M.D., Ken-ya Nishizawa, M.D., Ken-ichirou Nishikawa, M.D., Toshio Shibuya, M.D., Fumitaka Ohsuzu, M.D., Haruo Nakamura, M.D.
First Department of Internal Medicine, National Defense Medical College, Saitama, Japan
Summary
Background: Compensatory enlargement (CE) of atherosclerotic human arteries has been reported; however, the pattern of arterial remodeling in response to plaque formation is not unique.
Hypothesis: The study was undertaken to determine the extent of coronary artery compensatory enlargement at stenotic lesions and to correlate the arterial compensatory enlargement with risk factors.
Methods: We studied 62 patients with stable angina and de novo single-vessel disease using intravascular ultrasound and obtained good images in 42 patients (68%). The vessel cross-sectional area (VA), lumen cross-sectional area (LA), and plaque cross-sectional area (PA) were measured at the lesion site and at proximal and distal reference sites. Positive CE was defined as increase in VA of lesion site >10% compared with that of proximal reference site (CE group, n = 15); shrinkage was defined as reduction in VA of lesion site >10% compared with that of proximal reference site (S group, n = 14); inadequate CE was defined as intermediate between CE and S (IE group, n = 13). All subjects had coronary risk factors measured before this study.
Results: There was no difference in VA, LA, or PA among the three groups at the proximal and distal reference sites, nor in LA at the lesion site; however, VA and PA were significantly smaller in the S group than in the other groups (p<0.01). Of coronary risk factors, increased systolic blood pressure (SBP), increased diastolic blood pressure (DBP), and decreased high-density lipoprotein cholesterol (HDL-c) levels had the strongest association with shrinkage (p<0.05).
Conclusion: Hypertension and decreased HDL level may contribute to the shrinkage response in middle-aged patients with stable angina.
Key words: atherosclerosis, compensatory enlargement, coronary risk factors
Presented in part at the 48th Scientific Sessions of the American College of Cardiology, New Orleans, La., March 9, 1999.
Address for reprints:
Koh Arakawa, M.D.
The First Department of Medicine
National Defense Medical College
3-2, Namiki, Tokorozawa
Saitama, 359-0042 Japan
Received: July 5, 2000
Accepted with revision: October 25, 2000