Heart 1998;79:109-110 ( February )
Editorial
Coronary artery remodelling
| The first 150 words of the full text of this article appear below. |
Intravascular ultrasound shows that many coronary artery
atherosclerotic plaques do not encroach on the lumen and therefore are
angiographically invisible.1,2 The reason for this
phenomenon was first firmly established in human coronary arteries by
Glagov and colleagues.3 As a plaque develops the overall
cross sectional area of the coronary artery increases to accommodate
the plaque without any reduction in the cross sectional area of the
lumen. The process was termed compensatory enlargement. The increase in
total cross sectional area of the artery is achieved by two mechanisms.
One has been recognised by pathologists for many years4 and involves the media behind the plaque undergoing atrophy with fracture of the internal elastic lamina. The plaque is extruded outward
through the disrupted media leaving the lumen normal in shape and size
but giving the artery an external asymmetric bulge. The second
mechanism is more common and involves a rearrangement of smooth muscle
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