title: Plaque burden, arterial remodeling and plaque vulnerability: determined by systemic factors?
abstract: OBJECTIVE
  This study was designed to determine whether arterial remodeling and plaque vulnerability are influenced by systemic factors.
  
  
  BACKGROUND
  Atherosclerotic luminal narrowing is caused by gradual plaque growth and arterial remodeling. In the acute phase, luminal narrowing may be accelerated by acute thrombus formation, usually precipitated by rupture of a vulnerable plaque.
  
  
  METHODS
  Femoral arteries were obtained from elderly individuals at autopsy. Pairs of atherosclerotic femoral arteries from 42 individuals were examined. The arteries were divided in 1-cm intervals. Plaque size, the mode of arterial remodeling and histopathologic characteristics of plaque vulnerability (lipid-rich core and plaque inflammation) were compared between right and left femoral arteries obtained from the same individual. A role for systemic factors was assumed if a phenomenon was equally present in both arteries.
  
  
  RESULTS
  There was concordance in average plaque size (r(2) = 0.5, p < 0.001), expansive remodeling (kappa = 0.42, p = 0.007) and occurrence of plaques containing a large lipid-rich core (kappa = 0.60, p = 0.001), but no concordance in plaque inflammation (kappa = 0.067, p = 0.61) between right and left arteries.
  
  
  CONCLUSIONS
  These results suggest that not only the amount of atherosclerosis, but also arterial remodeling and lipid deposition in plaques, are influenced by systemic factors. The nonhomogeneous distribution of inflammation in atherosclerotic arteries supports the hypothesis that plaque inflammation is locally affected.
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Vink
authors.forename: A H
authors.initials: AH
authors.lastname: Schoneveld
authors.forename: W
authors.initials: W
authors.lastname: Richard
authors.forename: D P
authors.initials: DP
authors.lastname: de Kleijn
authors.forename: E
authors.initials: E
authors.lastname: Falk
authors.forename: C
authors.initials: C
authors.lastname: Borst
authors.forename: G
authors.initials: G
authors.lastname: Pasterkamp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D005263:Femoral Artery / Q000737:chemistry / Q000473:pathology*; D006801:Humans; D008055:Lipids / Q000032:analysis; D008297:Male
chemical_list: D008055:Lipids