Improved stenosis geometry by quantitative coronary arteriography after vigorous risk factor modification

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Abstract

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, thereby documenting the multidimensional characteristics of regressing coronary artery disease in humans.

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  • Cited by (0)

    This study was supported in part by Grants RO1 HL 26862, HL 26885, HL 42554 and HL 28356, from the National Institutes of Health, Bethesda, Maryland; the Houston Endowment Foundation, the Enron Corporation, Gerald D. Hines Interests, the Henry J. Kaiser Family Foundation, the Fetzer Institute, Continental Airlines, the Nathan Cummings Foundation, Bucksbaüm Foundation, the Pritzker Foundation, the Gross Foundation, the Moldaw Foundation, and as a joint collaborative project with the Clayton Foundation for Research, Houston, Texas.

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