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Titolo:
Atheromas that cause fatal thrombosis are usually large and frequently accompanied by vessel enlargement
Autore:
Bezerra, HG; Higuchi, MD; Gutierrez, PS; Palomino, SA; Silvestre, JML; Libby, P; Ramires, JAF;
Indirizzi:
Univ Sao Paulo, Sch Med, Heart Inst InCor, BR-05403000 Sao Paulo, Brazil Univ Sao Paulo Sao Paulo Brazil BR-05403000 BC05403000 Sao Paulo, Brazil Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA HarvardUniv Boston MA USA 02115 mens Hosp, Sch Med, Boston, MA 02115 USA
Titolo Testata:
CARDIOVASCULAR PATHOLOGY
fascicolo: 4, volume: 10, anno: 2001,
pagine: 189 - 196
SICI:
1054-8807(200107/08)10:4<189:ATCFTA>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; VIVO INTRAVASCULAR ULTRASOUND; MYOCARDIAL-INFARCTION; PLAQUE RUPTURE; COMPENSATORY ENLARGEMENT; ATHEROSCLEROTIC PLAQUES; LUMINAL STENOSIS; ANGIOGRAPHY; IMPACT; DETERMINANT;
Keywords:
atherosclerosis; remodeling; plaque; myocardial infarction; pathology;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Bezerra, HG Univ Sao Paulo, Sch Med, Heart Inst InCor, Av Dr Eneas Carvalho de Aguiar 44, BR-05403000 Sao Paulo, Brazil Univ Sao Paulo Av Dr Eneas Carvalho de Aguiar 44 Sao Paulo Brazil BR-05403000 BC
Citazione:
H.G. Bezerra et al., "Atheromas that cause fatal thrombosis are usually large and frequently accompanied by vessel enlargement", CARDIO PATH, 10(4), 2001, pp. 189-196

Abstract

Several lines of clinical evidence show that AMI frequently occurs at sites with mild to moderate degree of coronary stenosis. The degree of luminal stenosis depends on plaque deposition and degree of vessel remodeling, features poorly assessed by coronary angiography. This postmortem study tested the hypothesis that the size of coronary atheroma and the type of remodeling distinguish culprit lesion responsible for fatal AMI from equi-stenotic nonculprit lesion in the same coronary tree. The main coronary branches from36 consecutive patients with fatal AMI were studied. The culprit lesion (Group 1) and an equi-stenotic nonculprit segment (Group 2) obtained in measurements of another coronary branch from the same patient were compared. Morphometry and plaque composition was assessed in both groups. Compared to Group 2, Group 1 had larger areas of plaque 9.6 vs. 4.7 mm(2), vessel 12.7 vs. 7.4 mm(2) and lumen 1.7 vs. 1.2 mm(2); (P < .01). Positive remodeling wasmore frequent in Group I than Group 2: 21/30 (70%) vs. 8/26 (31%). Plaque area correlated positively with lipid core and macrophages and negatively with fibrosis and smooth muscle cells. Atherosclerotic plaques that cause fatal thrombosis are more frequently positively remodeled and tend to be larger than nonculprit plaques with the same degree of cross-sectional stenosis. We tested whether arterial remodeling and plaque size vary between segments containing a fatal thrombosed plaque versus an equi-stenotic nonculprit plaque. Culprit vessel segments had higher cross-sectional areas of intimalplaque and of vessel wall than equi-stenotic nonculprit plaques. The cross-sectional area of the vessel correlated positively with both the lipid core area and CD68(+) macrophage content, and negatively with fibrosis area and smooth muscle cell content. These results add elements explaining limitations of angiography in identifying plaques and provide new insights into the role of remodeling in plaque instability. (C) 2001 Elsevier Science Inc. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 09:35:03