Circulation, Vol 89, 2570-2577, Copyright © 1994 by American Heart Association
DW Losordo, K Rosenfield, J Kaufman, A Pieczek and JM Isner
BACKGROUND: Previous postmortem studies have demonstrated compensatory
enlargement of atherosclerotic arteries in animal models and patients.
Conclusions regarding these changes were drawn based on a comparison of the
dimensions of diseased arteries in one group of subjects with the
dimensions of normal arteries in another group. This method admits
potential confounding variables, such as demographics and other disease
states, which might also have an impact on arterial size. METHODS AND
RESULTS: Using intravascular ultrasound, we studied a total of 62 paired,
adjacent normal and diseased sites in the superficial femoral arteries of
20 patients undergoing peripheral vascular interventions. Morphological
assessment was performed using a computer-based image analysis system.
Measurements were made of the cross-sectional area of the arterial lumen,
the atherosclerotic plaque, and the outer border of the artery. These
dimensions were then compared to determine the effects of progressive
atherosclerosis on arterial morphology. Luminal cross-sectional area
decreased from 21.1 +/- 2.2 mm2 in normal segments to 16.7 +/- 0.8 mm2 (P =
.0001) in adjacent atherosclerotic segments. Similarly, minimal luminal
diameter decreased from 5.7 +/- 0.2 to 5.0 +/- 0.1 mm2, and maximal luminal
diameter decreased from 6.2 +/- 0.2 to 5.7 +/- 0.2 mm2. At these same
sites, total arterial area was 32.9 +/- 1.6 and 37.9 +/- 1.9 mm2 (P =
.0001) in normal and diseased segments, respectively. Minimal and maximal
arterial diameters demonstrated similar increases (7.3 +/- 0.2 to 7.7 +/-
0.2 mm2 [P = .0015] and 7.6 +/- 0.2 to 8.3 +/- 0.2 mm2 [P = .0001],
respectively). Regression analysis disclosed correlation of the
cross-sectional area of plaque to the total arterial area (R = .70, P =
.0001). CONCLUSIONS: Human arteries enlarge in response to progressive
atherosclerosis. This compensatory mechanism results in an increase in
arterial size that is proportionate to the cross-sectional area of plaque
that has accumulated in the vessel. Intravascular ultrasound demonstrates
that this process is focal compensatory enlargement at discrete sites of
atherosclerotic narrowing immediately adjacent to more normal areas in
which arterial size is smaller.
ARTICLES
Focal compensatory enlargement of human arteries in response to progressive atherosclerosis. In vivo documentation using intravascular ultrasound
Department of Medicine (Cardiology), St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA 02135.
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|
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|
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|
|
|
|
|
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|
|
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|
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|
|
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|
|
|
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|
|
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|
|
|
|
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|
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|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
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|
|
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