RELATION BETWEEN CORONARY-ARTERY GEOMETRY AND THE DISTRIBUTION OF EARLY SUDANOPHILIC LESIONS
RELATION BETWEEN CORONARY-ARTERY GEOMETRY AND THE DISTRIBUTION OF EARLY SUDANOPHILIC LESIONS
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DOI：
10.1016/0021-9150(93)90128-h
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发表时间：
1993-01-25
期刊：
影响因子：
5.3
通讯作者：
SEED, WA
中科院分区：
文献类型：
--
作者：
FRIEDMAN, MH;BRINKMAN, AM;SEED, WA
采用标准化的疾病严重程度指数，研究冠状动脉左回旋支（LCX）和左前降支（LAD）在左冠状动脉主干（LM）分叉处形成的角度与LCX和LAD近端嗜苏丹病位置之间的关系（相对近端受累，RPI），以将几何结构对疾病易感性的局部影响与其他风险因素的影响隔离开来。对15个心脏的左冠状动脉系统的多平面血管造影片进行数字化和处理，以形成每个冠状动脉段的管腔中心线（称为“轴”）的三维表示;从重建中客观计算LM分支角。将冠状动脉血管原位固定，从心脏中取出，纵向切开并用苏丹IV染色。通过将每个血管前1 cm内的嗜苏丹百分比除以前5 cm内的嗜苏丹百分比，获得LAD和LCX的RPI。RPI与LM分支角度呈负相关，提示LM分支角度小可能是子血管近端动脉粥样硬化疾病的“几何危险因素”。LCX的相关性强于LAD。这些结果似乎与动脉粥样硬化有利的概念一致，即在脉动循环的相当大的部分中，较大范围的血管经历接近零的流体动力学壁剪切。
The relationship between the angle formed by the left circumflex (LCX) and left anterior descending (LAD) coronary arteries at the bifurcation of the left main coronary artery (LM) and the location of sudanophilia in the proximal portions of the LCX and LAD, was investigated, using a normalized index of disease severity (relative proximal involvement, RPI) to isolate the local effect of geometry on the predisposition to disease from that of other risk factors. Multiplane angiograms of the left coronary artery system of 15 hearts were digitized and processed to form a three-dimensional representation of the centerline of the lumen (termed the 'axis') of each coronary segment; the LM branch angle was objectively computed from the reconstruction. The coronary vessels were fixed in situ, removed from the hearts, opened longitudinally and stained with Sudan IV. The RPIs of the LAD and LCX were obtained by dividing the percentage sudanophilia seen en face in the first 1 cm of each vessel by the percentage sudanophilia in the first 5 cm. RPI was correlated negatively with LM branch angle, suggesting that a small LM branch angle may be a 'geometric risk factor' for proximal atherosclerotic disease in the daughter vessels. The correlation was stronger for the LCX than the LAD. These results would appear to be consistent with the notion that atherosclerosis is favored where a larger extent of the vessel experiences fluid dynamic wall shears near zero for an appreciable part of the pulsatile cycle.