title: Contrast layering: late clearance of contrast dye--a novel angiographic phenomenon of early atherosclerosis.
abstract: Patients with angiographically normal coronary arteries sometimes exhibit delayed clearance of contrast medium. This contrast layering (CL) was tested with intravascular ultrasound (IVUS) and markers of endothelial dysfunction and oxidative stress. The study group (n = 26) consisted of patients with CL and the control group (n = 32) comprised patients with normal coronary arteries despite angina symptoms. The CL was observed in 36 coronary arteries of 26 patients in the study group. Total antioxidant status and nitric oxide levels were significantly lower; total oxidant status, malondialdehyde plasma levels, and oxidative stress index were significantly higher in patients with CL than in controls. The IVUS studies revealed that atherosclerotic plaque burden, fibrous tissue, dense calcific tissue, and necrotic core ratios were significantly higher in the coronary segments with CL compared with adjacent normal segments. These results support the concept of CL as a new angiographic appearance of early atherosclerosis.
authors.affiliation: Department of Cardiology, Bakirkoy Dr Sadi Konuk Research and Education Hospital, Istanbul, Turkey ilkermuratcaglar@gmail.com.
authors.forename: Ilker Murat
authors.initials: IM
authors.lastname: Caglar
authors.affiliation: Department of Cardiology, Bakirkoy Dr Sadi Konuk Research and Education Hospital, Istanbul, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Demir
authors.affiliation: Department of Cardiology, Istanbul Research and Education Hospital, Istanbul, Turkey.
authors.forename: Fatma Nihan Turhan
authors.initials: FN
authors.lastname: Caglar
authors.affiliation: Department of Cardiology, Bakirkoy Dr Sadi Konuk Research and Education Hospital, Istanbul, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Vural
authors.affiliation: Department of Cardiovascular Surgery, Istanbul University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ugurlucan
authors.affiliation: Department of Cardiology, Bakirkoy Dr Sadi Konuk Research and Education Hospital, Istanbul, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Ciftci
authors.affiliation: Department of Cardiology, Bakirkoy Dr Sadi Konuk Research and Education Hospital, Istanbul, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Ungan
authors.affiliation: Department of Clinical Biochemistry, Bakirkoy Dr. Sadi Konuk Research and Education Hospital, Istanbul, Turkey.
authors.forename: Asuman
authors.initials: A
authors.lastname: Gedikbasi
authors.affiliation: Department of Cardiology, Kocaeli Derince Research and Education Hospital, Kocaeli, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Dasli
authors.affiliation: Department of Cardiology, Bakirkoy Dr Sadi Konuk Research and Education Hospital, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Karakaya
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003287:Contrast Media / Q000493:pharmacokinetics*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000378:metabolism; D042241:Early Diagnosis; D005260:Female; D005355:Fibrosis; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009336:Necrosis; D009569:Nitric Oxide / Q000097:blood; D018384:Oxidative Stress; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D014421:Turkey; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000000981:diagnostic imaging
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D009569:Nitric Oxide; D007472:Iohexol; D008315:Malondialdehyde; C038192:iopromide
keywords: atherosclerosis; coronary artery disease; endothelial dysfunction; intravascular ultrasonography; oxidative stress