Determinants of Arterial Wall Remodeling During Lipid-Lowering Therapy
- 20 June 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 113 (24), 2826-2834
- https://doi.org/10.1161/circulationaha.105.585703
Abstract
Background— Coronary plaque progression and instability are associated with expansive remodeling of the arterial wall. However, the remodeling response during plaque-stabilizing therapy and its relationship to markers of lipid metabolism and inflammation are incompletely understood. Methods and Results— Serial intravascular ultrasound (IVUS) data from the Reversal of Atherosclerosis with Aggressive Lipid Lowering Therapy (REVERSAL) trial were obtained during 18 months of intensive versus moderate lipid-lowering therapy. In a subgroup of 210 patients, focal coronary lesions with mild luminal narrowing were identified. Lumen area, external elastic membrane (EEM) area, and plaque area were determined at the lesion and proximal reference sites at baseline and during follow-up. The remodeling ratio (RR) was calculated by dividing the lesion EEM area by the reference EEM area. The relationship between the change in remodeling, change in plaque area, lipid profile, and inflammatory markers was examined. At the lesion site, a progression in plaque area (8.9±25.7%) and a decrease in the RR (−3.0±11.2%) occurred during follow-up. In multivariable analyses, the percentage change in plaque area (PPP=0.027), and hypertension at baseline (P=0.014) showed a significant, direct relation with the RR at follow-up. Lesion location in the right coronary artery (P=0.006), percentage change in triglyceride levels (P=0.049), and age (P=0.037) demonstrated a significant, inverse relation with the RR at follow-up. Changes in LDL cholesterol, HDL cholesterol, and treatment group demonstrated no significant associations. Conclusions— Constrictive remodeling of the arterial wall was observed during plaque-stabilizing therapy with statin medications and appears related to their antiinflammatory effects.This publication has 26 references indexed in Scilit:
- Compensatory Vascular Remodeling During Atherosclerotic Lesion Growth Depends on Matrix Metalloproteinase-9 ActivityArteriosclerosis, Thrombosis, and Vascular Biology, 2004
- Spectrum of remodeling behavior observed with serial Long-Term (≥12 months) Follow-Up intravascular ultrasound studies in left main coronary arteriesThe American Journal of Cardiology, 2004
- Markers of Inflammation and Cardiovascular DiseaseCirculation, 2003
- Coronary Plaque Classification With Intravascular Ultrasound Radiofrequency Data AnalysisCirculation, 2002
- Transforming Growth Factor-β Mediates Balance Between Inflammation and Fibrosis During Plaque ProgressionArteriosclerosis, Thrombosis, and Vascular Biology, 2002
- American College of Cardiology clinical expert consensus document on standards for acquisition, measurement and reporting of intravascular ultrasound studies (ivus): A report of the american college of cardiology task force on clinical expert consensus documents developed in collaboration with the european society of cardiology endorsed by the society of cardiac angiography and interventionsJournal of the American College of Cardiology, 2001
- Clinical application and image interpretation in intracoronary ultrasoundEuropean Heart Journal, 1998
- Atherosclerosis in angiographically “normal” coronary artery reference segments: An intravascular ultrasound study with clinical correlationsJournal of the American College of Cardiology, 1995
- Compensatory Enlargement of Human Atherosclerotic Coronary ArteriesThe New England Journal of Medicine, 1987
- Physicochemical and histological changes in the arterial wall of nonhuman primates during progression and regression of atherosclerosis.JCI Insight, 1984