Adaptive Enlargement of Arteries in Response to Increased Flow and Increased Intimal Plaque
We studied adaptive changes in artery diameter in response to increased blood flow and increasing intimai plaque. Experimental increase in blood flow through an arteriovenous fistula resulted in an increase in lumen diameter such that wall shear stress was normalized. Increasing intimai plaque in human coronary arteries resulted in arterial enlargement which acted to counter or prevent lumen stenosis. Such enlargement was effective in preventing left main coronary stenosis in arteries with plaques occupying less than 40% of the internal elastic lamina. In the distal left anterior descending coronary artery, the most diseased arteries overcompensated and had enlargement of the lumen despite the presence of extensive plaques. The development of stenosis, preservation of a normal lumen caliber or lumen enlargement may depend on local differences in response and on the relative rates of plaque deposition and compensatory arterial enlargement.
KeywordsWall Shear Stress Left Anterior Descend Lumen Diameter Left Main Coronary Artery Lumen Area
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- .Zarins CK, Weisenberg E, Kolettis GJ, Stankunavicius R, Glagov S. Differential enlargement of artery segments in response to enlarging atherosclerotic plaques. Submitted to the J of Vasc Surg.Google Scholar