Variations of Remodeling in Response to Left Main Atherosclerosis Assessed With Intravascular Ultrasound In Vivo

• Published in: The American journal of cardiology 1997-12, Vol.80 (11), p.1408-1413
• Main Authors: von Birgelen, Clemens, Airiian, Sergei G., Mintz, Gary S., van der Giessen, Wim J., Foley, David P., Roelandt, Jos R.T.C., Serruys, Patrick W., de Feyter, Pim J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary heart disease; Coronary vessels; Coronary Vessels - diagnostic imaging; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Prospective Studies; Regression Analysis; Reproducibility of Results; Ultrasonic imaging; Ultrasonography, Interventional
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(97)00700-5

Histopathologic studies have demonstrated that vessels enlarge to compensate for an increase in plaque burden; this has been confirmed in vivo using intravascular ultrasound (IVUS). The initial studies suggested a biphasic course of lesion formation with (1) preservation of lumen dimensions up to a plaque burden of approximately 40%, and (2) luminal narrowing as plaque burden further increases. In this study, we used IVUS and angiography to assess the extent of left main (LM) atherosclerosis in 107 patients undergoing catheter-based procedures of the left anterior descending or left circumflex coronary arteries. Using IVUS, atherosclerotic plaques were found in all LM arteries, but only 26 (24%) had varying degrees of luminal narrowing on the angiogram. Nevertheless, there was an inverse relation (r = −0.62, p 40% (or >30%), but persisted at plaque burden values of 20% to 40%. In addition, LM arteries with a plaque burden