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Distribution and severity of atherosclerosis in the coronary arteries
Insights
This study of human hearts reveals a strong link between atherosclerosis and coronary artery narrowing. Significant disease in one area often predicts involvement in other coronary arteries, impacting surgical candidacy.
Area of Science:
- Cardiovascular Pathology
- Human Anatomy
Background:
- Atherosclerosis is a leading cause of cardiovascular disease.
- Accurate assessment of coronary artery disease is crucial for treatment decisions.
Purpose of the Study:
- To correlate gross findings of atherosclerosis with coronary angiography in human hearts.
- To investigate the patterns of coronary artery disease distribution.
Main Methods:
- Postmortem examination of 93 human hearts.
- Gross inspection for atherosclerosis.
- Postmortem coronary angiography for luminal narrowing assessment.
Main Results:
- High correlation between gross atherosclerosis and luminal narrowing.
- 30% of proximal disease cases showed distal coronary artery disease.
- 75% likelihood of other vessels involvement when one coronary artery has severe proximal disease.
- Distal disease nearly always accompanied by proximal involvement.
Conclusions:
- Atherosclerosis patterns are predictable in coronary arteries.
- Understanding disease distribution aids in patient selection for coronary artery bypass grafting.
Abstract:
A postmortem study of 93 human hearts was undertaken. Gross inspection was used to determine the degree of atherosclerosis and postmortem coronary angiography to estimate the degree of luminal narrowing. The findings indicate the following: (1) There is high correlation between the estimates of luminal narrowing in the gross specimen and the presence of significant atherosclerosis. (2) Approximately 30 per cent of vessels with significant proximal disease will have significant distal coronary artery disease. (3) When one coronary artery is involved with severe proximal atherosclerosis, either of the other two vessels are likely to be involved, with a frequency of 75 per cent ormore. (4) When significant distal disease is present the proximal vessel is nearly always involved. (5) Patient selection prior to referral to surgery may be partly responsible for the over 90 per cent operability rate in patients undergoing coronary artery bypass grafting.