Coronary remodeling of proximal and distal stenotic atherosclerotic plaques within the same artery by intravascular ultrasound study

The aim of this intravascular ultrasound study was to compare the type and the degree of vessel remodeling in proximal and distal de novo lesions with in the same coronary artery in patients with stable angina pectoris. Sevent y-six de novo coronary artery lesions in 38 coronary arteries of 38 patient s were imaged by intravascular ultrasound. The vessel area (VA) within the external elastic lamina and the lumen area (LA) were measured, and the wall area (VA-LA) was calculated at the lesion site, and the proximal and dista l reference sites, The VA ratio was defined as (lesion VA/average of the pr oximal and distal reference VAs) to represent the degree of vessel remodeli ng. The proximal coronary segments showed compensatory enlargement more of- ten (68% vs 29%, p <0.01) than the distal segments, and the VA ratio at th e lesion site was significantly larger (1.1 +/- 0.3 vs 1.0 +/- 0.2, p < 0.0 1) in proximal segments than in distal segments. The type of coronary remod eling was discordant in 61% and concordant in only 39% of coronary arteries between the proximal and distal segments. The type of coronary remodeling of proximal and distal coronary lesions was inhomogeneous, even within the same vessel. Proximal coronary segments showed more prominent compensatory enlargement than distal segments, which have a similar degree of luminal na rrowings. (C) 2001 by Excerpta Medica, Inc.