Angiographie morphology and the pathogenesis of unstable angina pectoris

John A. Ambrose, Stephen L. Winters, Audrey Stern, Angie Eng, Louis E. Teichholz, Richard Gorlin, Valentin Fuster

Research output: Contribution to journalEditorial

638 Citations (Scopus)

Abstract

In 110 patients with either stable or unstable angina, the morphology of coronary artery lesions was qualitatively assessed at angiography. Each obstruction reducing the luminal diameter of the vessel by 50% or greater was categorized into one of the following morphologic groups: concentric (symmetric narrowing); type I eccentric (asymmetric narrowing with smooth borders and a broad neck); type II eccentric (asymmetric with a narrow neck or irregular borders, or both); and multiple irregular coronary narrowings in series. For the entire group, type II eccentric lesions were significantly more frequent in the 63 patients with unstable angina (p < 0.001), whereas concentric and type I eccentric lesions were seen more frequently in the 47 patients with stable angina (p < 0.05). Type II eccentric lesions were also present in 29 of 41 arteries in patients with unstable angina compared with 4 of 25 arteries in those with stable angina (p < 0.0001) in whom an “angina-producing” artery could be identified. Therefore, type II eccentric lesions are frequent in patients with unstable angina and probably represent ruptured atherosclerotic plaques or partially occlusive thrombi, or both. A temporary decrease in coronary perfusion secondary to these plaques with or without superimposed transient platelet thrombi or altered vasomotor tone may be responsible for chest pain in some of these patients with unstable angina.

Original languageEnglish (US)
Pages (from-to)609-616
Number of pages8
JournalJournal of the American College of Cardiology
Volume5
Issue number3
DOIs
StatePublished - Jan 1 1985

Fingerprint

Unstable Angina
Stable Angina
Arteries
Thrombosis
Neck
Atherosclerotic Plaques
Chest Pain
Coronary Vessels
Angiography
Blood Platelets
Perfusion

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Ambrose, John A. ; Winters, Stephen L. ; Stern, Audrey ; Eng, Angie ; Teichholz, Louis E. ; Gorlin, Richard ; Fuster, Valentin. / Angiographie morphology and the pathogenesis of unstable angina pectoris. In: Journal of the American College of Cardiology. 1985 ; Vol. 5, No. 3. pp. 609-616.
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abstract = "In 110 patients with either stable or unstable angina, the morphology of coronary artery lesions was qualitatively assessed at angiography. Each obstruction reducing the luminal diameter of the vessel by 50{\%} or greater was categorized into one of the following morphologic groups: concentric (symmetric narrowing); type I eccentric (asymmetric narrowing with smooth borders and a broad neck); type II eccentric (asymmetric with a narrow neck or irregular borders, or both); and multiple irregular coronary narrowings in series. For the entire group, type II eccentric lesions were significantly more frequent in the 63 patients with unstable angina (p < 0.001), whereas concentric and type I eccentric lesions were seen more frequently in the 47 patients with stable angina (p < 0.05). Type II eccentric lesions were also present in 29 of 41 arteries in patients with unstable angina compared with 4 of 25 arteries in those with stable angina (p < 0.0001) in whom an “angina-producing” artery could be identified. Therefore, type II eccentric lesions are frequent in patients with unstable angina and probably represent ruptured atherosclerotic plaques or partially occlusive thrombi, or both. A temporary decrease in coronary perfusion secondary to these plaques with or without superimposed transient platelet thrombi or altered vasomotor tone may be responsible for chest pain in some of these patients with unstable angina.",
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Angiographie morphology and the pathogenesis of unstable angina pectoris. / Ambrose, John A.; Winters, Stephen L.; Stern, Audrey; Eng, Angie; Teichholz, Louis E.; Gorlin, Richard; Fuster, Valentin.

In: Journal of the American College of Cardiology, Vol. 5, No. 3, 01.01.1985, p. 609-616.

Research output: Contribution to journalEditorial

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AU - Ambrose, John A.

AU - Winters, Stephen L.

AU - Stern, Audrey

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AU - Fuster, Valentin

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