title: Coronary endothelial dysfunction is associated with inflammation and vasa vasorum proliferation in patients with early atherosclerosis.
abstract: OBJECTIVE
  Endothelial dysfunction is an early manifestation of atherosclerosis. Inflammation and vasa vasorum play a pivotal role in the pathophysiology of plaque initiation, development, and complications. Optical coherence tomography allows high-resolution imaging of tissue microstructure. Therefore, the aim of this study was to test the hypothesis that segments with endothelial dysfunction show macrophages and vasa vasorum in patients with early coronary artery disease.
  
  
  RESULTS
  Optical coherence tomography images were obtained from 40 patients with mild coronary atherosclerosis who underwent coronary endothelial function assessment. Optical coherence tomography findings, including macrophages and microchannels, were evaluated in 76 coronary segments corresponding to those in endothelial response to acetylcholine. Coronary artery diameter change in response to acetylcholine was more severe in segments showing macrophages (-17.7±14.7% versus -6.3±13.9%; P<0.01) and microchannels (-15.9±15.9% versus -6.4±13.5%; P<0.01) than those without. There were increasing trends of the prevalence of macrophages and microchannels with endothelial dysfunction as stratified by quartiles of coronary artery diameter change (P<0.01 and P=0.02 for trend, respectively). In particular, segments with both macrophages and microchannels (n=12) tended to have worse endothelial function than those with macrophages alone (n=15) and microchannels alone (n=15; -22.1±14.6% versus -10.9±15.6% and -10.9±15.6%; P=0.07 and P=0.06, respectively).
  
  
  CONCLUSIONS
  Epicardial endothelial dysfunction was associated with optical coherence tomography -identified macrophages and microchannels in mild coronary atherosclerosis. The current study further supports the role of inflammation and vasa vasorum proliferation in the early stage of coronary atherosclerosis.
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.).
authors.forename: Byoung-Joo
authors.initials: BJ
authors.lastname: Choi
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.).
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.).
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Aoki
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.).
authors.forename: Taek-Geun
authors.initials: TG
authors.lastname: Kwon
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.).
authors.forename: Abhiram
authors.initials: A
authors.lastname: Prasad
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.).
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gulati
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.).
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Lennon
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.).
authors.forename: Lilach O
authors.initials: LO
authors.lastname: Lerman
authors.affiliation: From the Division of Cardiovascular Disease (B-J.C., Y.M., T.A., T-G.K., A.P., R.G., A.L.), Division of Biomedical Statistics and Informatics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo Clinic, Rochester, MN; and Department of Cardiology, Ajou University School of Medicine, Suwon, South Korea (B-J.C.). Lerman.Amir@mayo.edu.
authors.forename: Amir
authors.initials: A
authors.lastname: Lerman
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000328:Adult; D000368:Aged; D002452:Cell Count; D049109:Cell Proliferation / Q000502:physiology*; D003324:Coronary Artery Disease / Q000473:pathology / Q000503:physiopathology*; D003331:Coronary Vessels / Q000187:drug effects / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D008264:Macrophages / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence; D014651:Vasa Vasorum / Q000473:pathology* / Q000503:physiopathology; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D000109:Acetylcholine
keywords: coronary disease; inflammation; optical coherence tomography