Topography of intimal thickening in the left coronary artery of children compared with the topography of atherosclerosis.

Abstract

Newborn children already have marked intimal thickenings in their coronary arteries. The magnitude of such thickenings increases with age and is associated with the coronary artery disease mortality of the grandparents. Topographies of such thickenings were investigated. Cross-sections of the coronary arteries of 71 autopsied children were studied morphometrically at 200 microns intervals. A three-dimensional model was constructed from 16 serial sections by digitizing both the inner and the outer borders of the serial sections. A B-spline surface was constructed. The arterial media was thinner under large intimal thickening. In a three-dimensional model the luminal surface could be seen through the outer surface. Intimal thickening narrowed the coronary lumen. In a sagittal longitudinal cross-section along the course of the coronary artery, a hypothetical coronary "angiocardiogram' demonstrated a narrowing in the proximal coronary artery. Intimal thickenings that narrow the coronary artery lumen appear in the beginning of the left coronary artery in children, as does atherosclerosis in adults.