Effects of cyclic flexion of coronary arteries on progression of atherosclerosis

Abstract The purpose of this investigation was to test the hypothesis that cyclic flexion of the coronary arteries contributes to the progression of atherosclerotic plaques. Coronary arteriograms were evaluated in 33 unselected patients who under went 2 studies over a period of 25 ± 16 months (mean ± SD). Among the 33 patients, 103 plaques were identified. Plaques that showed progression were compared with plaques that showed no progression. The angle of flexion that occurred during systole at the site of the plaque was measured on the first arteriogram. In comparing progression versus no progression, the interval between arteriogams was 29 ± 18 versus 23 ± 14 months (p = NS) and percent stenosis at the first arteriogam was 42 ± 28 versus 45 ± 19% (p = NS). Percent stenosis at the time of the second arteriogram among plaques that progressed was 78 ± 21%, and by definition, it remained 45 ± 19% among those that did not progress. Among arteries with plaques that showed a progression of stenosis, the angle of flexion during systole was 19 ± 13° versus 9 ± 15° among arteries with plaques that did not progress (p