Coronary artery necroses and calcification in chronic coronary heart disease

• Main Authors: Valentin Sergeevich Zhdanov, Nina Mikhaylovna Cherpachenko, Iraida Petrovna Drobkova, Svetlana Petrovna Veselova, Tat'yana Petrovna Shlychkova, V S Zhdanov, N M Cherpachenko, I P Drobkova, S P Veselova, T P Shlychkova
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2010-12-01
• Series: Терапевтический архив
• Subjects: atherosclerosis; coronary arteries; calcification; necrosis; unstable atherosclerotic plaques
• Online Access: https://ter-arkhiv.ru/0040-3660/article/view/30718
• ISSN: 0040-3660; 2309-5342

Aim. To study some particularly inadequately studied mechanisms for the development of coronary artery calcification (CAC), which are unassociated with calcified atheromatous masses of atherosclerotic plaques. Subjects and methods. Endarterectomized coronary artery (CA) segments obtained during aortocoronary bypass surgery were pathomorphologically studied in 150 patients aged 49-72 years with coronary heart disease (CHD). CAC was found in 92% of cases. Two types of CAC were identified: one of them was associated with calcified atheromatous masses of atherosclerotic plaques; the other was related to necroses in the fibrous plaque parts. The atheromatous masses exhibited calcareous deposits as fine-grained masses of small extent. In chronic CHD, morphological signs of instability of atherosclerotic plaques were observed in 23.3% of cases, these being associated with lamellar CAC in two thirds. Conclusion. Calcification in the necrotic area of fibrous parts of stenotic plaques is typical of chronic CHD and is frequently attended by the development of large-focal calcareous deposits generally as laminas (lamellar calcification). Impaired transmural perfusion of plasma is noted to be involved in the development of necroses in stenotic CA atherosclerotic plaques.