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Coronary arterial remodeling: from bench to bedside.
Paul Schoenhagen1, Steven E Nissen, E Murat Tuzcu
1The Cleveland Clinic Foundation, F-25, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Current Atherosclerosis Reports
|February 8, 2003
Summary
Coronary arterial remodeling involves vessel size changes in atherosclerosis. Positive remodeling expands the vessel, while negative remodeling shrinks it, impacting lumen size and plaque vulnerability. Understanding these changes aids disease prevention.
Area of Science:
- Cardiovascular Biology
- Pathophysiology
- Medical Imaging
Background:
- Coronary arterial remodeling alters vessel size at atherosclerotic lesion sites.
- Positive remodeling maintains lumen size, while negative remodeling causes stenosis, independent of plaque accumulation.
- Plaque progression/regression is not always reflected in luminal size due to these adaptive changes.
Purpose of the Study:
- To explore the complex pathophysiologic role of arterial remodeling beyond a compensatory process.
- To investigate the association between positive arterial remodeling, inflammation, and plaque vulnerability.
- To highlight the utility of in vivo imaging for observing arterial remodeling in clinical settings.
Main Methods:
- Review of histologic studies on arterial remodeling.
- Analysis of associations between positive remodeling, inflammatory response, and plaque vulnerability.
- Evaluation of in vivo tomographic imaging techniques like intravascular ultrasound, CT, and MRI for observing remodeling.
Main Results:
- Histologic studies reveal a complex pathophysiologic role for arterial remodeling.
- A consistent association exists between positive arterial remodeling, local inflammation, and plaque vulnerability.
- In vivo imaging techniques enable clinical observation of arterial remodeling.
Conclusions:
- Arterial remodeling is a complex process influencing atherosclerotic lesion dynamics.
- Positive remodeling is linked to inflammation and vulnerable plaques.
- Integrating basic science with in vivo imaging can enhance understanding of plaque progression, regression, and vulnerability, potentially aiding disease prevention.