IMPROVED STENOSIS GEOMETRY BY QUANTITATIVE CORONARY ARTERIOGRAPHY AFTER VIGOROUS RISK FACTOR MODIFICATION

被引:78
作者
GOULD, KL
ORNISH, D
KIRKEEIDE, R
BROWN, S
STUART, Y
BUCHI, M
BILLINGS, J
ARMSTRONG, W
PORTS, T
SCHERWITZ, L
机构
[1] UNIV CALIF SAN FRANCISCO,CALIF PACIFIC MED CTR,PREVENT MED RES INST,SAN FRANCISCO,CA 94143
[2] UNIV CALIF BERKELEY,BERKELEY,CA 94720
关键词
D O I
10.1016/0002-9149(92)90781-S
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This study is a randomized, controlled, blinded, arteriographic trial to determine the effects of a low-cholesterol, low-fat, vegetarian diet, stress management and moderate aerobic exercise on geometric dimensions, shape and fluid dynamic characteristics of coronary artery stenoses in humans. Complex changes of different primary stenosis dimensions in opposite directions or to different degrees cause stenosis shape change with profound effects on fluid dynamic severity, not accounted for by simple percent narrowing. Accordingly, all stenosis dimensions were analyzed, including proximal, minimal, distal diameter, integrated length, exit angles and exit effects, determining stenosis shape and a single integrated measure of stenosis severity, stenosis flow reserve reflecting functional severity. In the control group, complex shape change and a stenosis- molding characteristic of statistically significant progressing severity occurred with worsening of stenosis flow reserve. In the treated group, complex shape change and stenosis molding characteristic of significant regressing severity was observed with improved stenosis flow reserve, there-by documenting the multidimensional characteristics of regressing coronary artery disease in humans.
引用
收藏
页码:845 / 853
页数:9
相关论文
共 35 条
[1]   HEMODYNAMIC SEQUELAE OF REGRESSION OF EXPERIMENTAL ATHEROSCLEROSIS [J].
ARMSTRONG, ML ;
HEISTAD, DD ;
MARCUS, ML ;
PIEGORS, DJ ;
ABBOUD, FM .
JOURNAL OF CLINICAL INVESTIGATION, 1983, 71 (01) :104-113
[2]   DIET, LIPOPROTEINS, AND THE PROGRESSION OF CORONARY ATHEROSCLEROSIS - THE LEIDEN INTERVENTION TRIAL [J].
ARNTZENIUS, AC ;
KROMHOUT, D ;
BARTH, JD ;
REIBER, JHC ;
BRUSCHKE, AVG ;
BUIS, B ;
VANGENT, CM ;
KEMPENVOOGD, N ;
STRIKWERDA, S ;
VANDERVELDE, EA .
NEW ENGLAND JOURNAL OF MEDICINE, 1985, 312 (13) :805-811
[3]   BENEFICIAL-EFFECTS OF COMBINED COLESTIPOL-NIACIN THERAPY ON CORONARY ATHEROSCLEROSIS AND CORONARY VENOUS BYPASS GRAFTS [J].
BLANKENHORN, DH ;
NESSIM, SA ;
JOHNSON, RL ;
SANMARCO, ME ;
AZEN, SP ;
CASHINHEMPHILL, L .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1987, 257 (23) :3233-3240
[4]   EFFECTS OF THERAPY WITH CHOLESTYRAMINE ON PROGRESSION OF CORONARY ARTERIOSCLEROSIS - RESULTS OF THE NHLBI TYPE-II CORONARY INTERVENTION STUDY [J].
BRENSIKE, JF ;
LEVY, RI ;
KELSEY, SF ;
PASSAMANI, ER ;
RICHARDSON, JM ;
LOH, IK ;
STONE, NJ ;
ALDRICH, RF ;
BATTAGLINI, JW ;
MORIARTY, DJ ;
FISHER, MR ;
FRIEDMAN, L ;
FRIEDEWALD, W ;
DETRE, KM ;
EPSTEIN, SE .
CIRCULATION, 1984, 69 (02) :313-324
[5]   ARTERIOGRAPHIC ASSESSMENT OF CORONARY ATHEROSCLEROSIS - REVIEW OF CURRENT METHODS, THEIR LIMITATIONS, AND CLINICAL-APPLICATIONS [J].
BROWN, BG ;
BOLSON, EL ;
DODGE, HT .
ARTERIOSCLEROSIS, 1982, 2 (01) :2-15
[6]   QUANTITATIVE CORONARY ARTERIOGRAPHY - ESTIMATION OF DIMENSIONS, HEMODYNAMIC RESISTANCE, AND ATHEROMA MASS OF CORONARY-ARTERY LESIONS USING ARTERIOGRAM AND DIGITAL COMPUTATION [J].
BROWN, BG ;
BOLSON, E ;
FRIMER, M ;
DODGE, HT .
CIRCULATION, 1977, 55 (02) :329-337
[7]   REGRESSION OF CORONARY-ARTERY DISEASE AS A RESULT OF INTENSIVE LIPID-LOWERING THERAPY IN MEN WITH HIGH-LEVELS OF APOLIPOPROTEIN-B [J].
BROWN, G ;
ALBERS, JJ ;
FISHER, LD ;
SCHAEFER, SM ;
LIN, JT ;
KAPLAN, C ;
ZHAO, XQ ;
BISSON, BD ;
FITZPATRICK, VF ;
DODGE, HT .
NEW ENGLAND JOURNAL OF MEDICINE, 1990, 323 (19) :1289-1298
[8]  
CARLSON LA, 1988, ACTA MED SCAND, V223, P405
[9]   EFFECT OF CLOFIBRATE ON PROGRESSION OF CORONARY-DISEASE - PROSPECTIVE ANGIOGRAPHIC STUDY IN MAN [J].
COHN, K ;
SAKAI, FJ ;
LANGSTON, MF .
AMERICAN HEART JOURNAL, 1975, 89 (05) :591-598
[10]   ASSESSMENT OF CORONARY-ARTERY DISEASE SEVERITY BY POSITRON EMISSION TOMOGRAPHY - COMPARISON WITH QUANTITATIVE ARTERIOGRAPHY IN 193 PATIENTS [J].
DEMER, LL ;
GOULD, KL ;
GOLDSTEIN, RA ;
KIRKEEIDE, RL ;
MULLANI, NA ;
SMALLING, RW ;
NISHIKAWA, A ;
MERHIGE, ME .
CIRCULATION, 1989, 79 (04) :825-835