title: Pressure-diameter relationship in human coronary arteries.
abstract: BACKGROUND
  To quantify the changes in arterial dimensions after the acute changes in pressure associated with percutaneous coronary intervention (PCI).
  
  
  RESULTS
  Forty-eight patients with one angiographically moderate-to-severe stenosis were included in the study. The pressure proximal and distal to the stenosis and the arterial diameter proximal and distal to the stenosis were measured at baseline, after intracoronary nitrates, and after stent PCI. In addition, in 8 patients distal pressure and coronary diameter were assessed while graded, controlled stenoses were created in the stented segment by progressive inflation of a balloon catheter. The mean diameter of the proximal coronary segment was 2.75 ± 0.08 mm, 2.92 ± 0.08 mm (+7.4%), and 3.10 ± 0.07 mm (+14.7%) at baseline, after nitrates and after PCI, respectively (P<0.001). The mean diameter of the distal coronary segment was 2.07 ± 0.09 mm, 2.23 ± 0.09 mm (+9.7%), and 2.5±0.07 mm (+28.4%) at baseline, after nitrates and after PCI, respectively (P<0.001). The increase in distal diameter correlated significantly with the increase in distal pressure after PCI (r(2)=0.57; P<0.001). When graded stenoses were created, a decrease in diameter of 18 ± 4% was observed with a pressure drop of 43 ± 5 mm Hg.
  
  
  CONCLUSIONS
  The diameter of coronary arteries markedly varies with their distending pressure. After re-establishment of a normal distending pressure by stenting of severe coronary stenoses, a proportional increase in vessel diameter is observed. This should be taken into account when choosing the stent diameter and is an argument to discourage direct stenting.
authors.affiliation: Cardiovascular Centre Aalst, OLV-Clinic, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Muller
authors.forename: Stylianos A
authors.initials: SA
authors.lastname: Pyxaras
authors.forename: Catalina
authors.initials: C
authors.lastname: Trana
authors.forename: Fabio
authors.initials: F
authors.lastname: Mangiacapra
authors.forename: Emanuele
authors.initials: E
authors.lastname: Barbato
authors.forename: William
authors.initials: W
authors.lastname: Wijns
authors.forename: Charles A
authors.initials: CA
authors.lastname: Taylor
authors.forename: Bernard
authors.initials: B
authors.lastname: De Bruyne
mesh_terms: D000368:Aged; D062186:Arterial Pressure / Q000187:drug effects; D006328:Cardiac Catheterization; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011474:Prosthesis Design; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate