Progression of coronary atherosclerosis quantified by analysis of 3-D reconstruction of left coronary arteries

Objectives: Quantitative measurements on three-dimensional (3-D) reconstructed coronary trees permit accurate evaluation of vascular volumes, lengths and diameters. We applied this technique to investigate diffuse luminal narrowing in patients with the clinical manifestation of progressive atherosclerosis. Methods: In 13 patients who presented repeatedly for coronary angioplasty (at least 4 years of invasive follow-up), left coronary arteries were reconstructed in 3-D from biplane coronary angiograms. Mean diameter, cross-sectional areas, total length, and volume were calculated for segments and branches. Five patients without coronary artery disease served as controls. Results: Patients with progressive coronary atherosclerosis demonstrated a significant reduction of total vascular volumes, mean diameters and cross-sectional areas at the initial investigation when compared with controls. Progressive luminal shrinkage occurred during follow-up (−0.04±0.13 mm per year and per segmental diameter). The progress of luminal narrowing in patients with coronary artery disease is related to the number of coronary risk factors and the duration of follow-up. Conclusion: Quantitative measurements on 3-D reconstructed coronary trees are a useful investigative tool for the assessment of progression of coronary atherosclerosis.