Cross-sectional area of the proximal portions of the three major epicardial coronary arteries in 98 necropsy patients with different coronary events. Relationship to heart weight, age and sex.

Abstract

The cross-sectional area (the portion enclosed by the internal elastic membrane) of histologic sections from the first 5 mm long segments of the right, left anterior descending and left circumflex coronary arteries was determined by videoplanimetry in 98 necropsy patients with coronary heart disease and in 46 control subjects who did not have significant coronary narrowing. Significant (P < 0.001) differences were observed in the mean cross-sectional area of each of the 3 major coronary arteries in the subgroups of coronary patients and among and between the control subjects. These differences resulted primarily from differences in heart weight and, to a slight extent, in age. Difference in sex was not significant. The 20 patients with angina pectoris had the smallest coronary arteries (mean cross-sectional area of each of the 60 arteries 6.0 mm2) and the smallest hearts (mean weight 386 g). The 18 patients with healed myocardial infarcts and intractable congestive heart failure had the largest coronary arteries (mean area 8.6 mm2) and the largest hearts (mean weight 588 g). The 23 patients with acute transmural myocardial infarcts and the 19 with sudden coronary death had similar-sized coronary arteries (mean area 7.6 mm2) and similar-sized hearts (mean weight 471 g). The 18 patients with healed myocardial infarcts, subsequently asymptomatic courses and noncardiac deaths had slightly enlarged arteries (mean area 6.9 mm2) and hearts (mean weight 430 g). The 31 control subjects with cancer and normal or near-normal-sized hearts (mean weight 309 g) had the smallest coronary arteries (mean area 5.0 mm2). The 16 controls with aortic valve disease had the largest hearts (mean weight 730 g) and the largest coronary arteries (mean area 9.6 mm2). When heart weights were equalized (450 g) older patients had larger coronary arteries than younger patients (mean area .ltoreq. 40 yr 6.5 mm2, 41-60 yr 6.8 mm2 and > 60 yr 7.6 mm2).