动脉粥样硬化进展时冠状动脉代偿性扩张与粥样斑块负荷无关:REVERSAL试验中连续血管内超声观察结果

查看全文 作　　者：Sipahi I.;Tuzcu [1]E.M.;Schoenhagen P.;郭俊 机构地区：[1]Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, United States 出　　处：《世界核心医学期刊文摘(心脏病学分册)》索引2006年第12期,共2页 摘　　要：Aims: On the basis of the evidence from autopsy studies, it is accepted that compensatory enlargement(remodelling) of coronary arteries during progression of atherosclerosis diminishes once atheroma burden(cross-sectional area stenosis) reaches ~40%. Our aim was to evaluate whether atheroma burden is a limiting factor for coronary arterial remodelling using in vivo serial intravascular ultrasound(IVUS). Methods and results: From the cohort of the Reversal of Atherosclerosis with Aggressive Lipid Lowering(REVERSAL) trial, we identified 210 focal coronary lesions at baseline IVUS. Of these, 128 lesions that had an increase in atheroma area at the 18-month follow-up IVUS were included in the analysis. Lesions were matched at baseline and follow-up. The increase in external elastic membrane(EEM) area for each mm2 increase in atheroma area was not significantly different in lesions with< 40 and ≥40%atheroma burden at baseline(1.62 vs. 1.28 mm2, P=0.30). There were no correlations between atheroma burden at baseline and change in EEM(r=0.02, P=0.86) or change in lumen(r=0.04, P=0.64) areas. Conclusion: Assessment of coronary arterial remodelling by serial IVUS revealed that compensatory remodelling is not limited by atheroma burden. Atheroma burden is not a determinant of arterial enlargement during the progression of atherosclerosis. 关 键 词：冠状动脉 粥样斑块 动脉粥样硬化 动脉硬化 血管内超声