Measurement by intracoronary ultrasound of in vivo arterial distensibility within atherosclerotic lesions.
Arterial distensibility is diminished by atherosclerosis. This process has not been well studied in the coronary arteries. The purpose of this study was to assess changes in coronary arterial distensibility in 4 groups of patients. Group I (n = 20) consisted of patients with normal vessels, group II (n = 40) with diseased undilated vessels, group III (n = 15) after successful percutaneous transluminal coronary angioplasty (PTCA), and Group IV (n = 20) after successful directional coronary atherectomy (DCA). Intracoronary ultrasound imaging was used to assess distensibility, plaque morphology and atherosclerotic burden (expressed as the percentage of total vessel cross-sectional area occupied by plaque: percent plaque area). Distensibility was defined as percent change in lumen area in a cardiac cycle. Group I (normal vessels) had a distensibility = 14 +/- 5%, which was significantly greater than that seen in group II (distensibility = 4 +/- 2%, p < 0.001). In undilated vessels, distensibility was related to the degree of atherosclerotic burden (r = 0.75). This relation was curvilinear with a marked decrease in distensibility when percent plaque area exceeded 30%. Distensibility in group III (after PTCA) was higher than in group II (10 +/- 3 vs 4 +/- 2%, p < 0.001) despite a larger plaque burden (percent plaque area of 56 +/- 12 vs 46 +/- 11%, p < 0.005). The distensibility in group IV (after DCA) was also higher than in group II (8 +/- 4 vs 4 +/- 2%, p < 0.001) despite a similar residual percent plaque area (49 +/- 13 vs 46 +/- 11%, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Reddy
K G
KG
Division of Cardiology, University Hospitals of Cleveland, Ohio 44106.
Suneja
R
R
Nair
R N
RN
Dhawale
P
P
Hodgson
J M
JM
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary / Q000379:methods; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology*