1997 by Excerpta Medica, Inc. 0002-9149/97/$17.00 699 All rights reserved. PII S0002-9149(96)00849-1 / 2w1a 0830 Mp 699 Wednesday Feb 12 04:39 PM EL–AJC (v. 79, no. 5 ’97) 0834 In summary, the inotropic effect of caffeine on the heart was significant in our study. These data suggest the importance of further investigation into the effects of caffeine on patients with known heart disease. Acknowledgment: The authors wish to thank Renee Kaufman for her involvement in this study. 1. Whitsett TL, Manion CV, Christensen HD. Cardiovascular effects of coffee and caffeine. Am J Cardiol 1984;53:918 – 922. 2. Walther FJ, Erickson R, Sims ME. Cardiovascular effects of caffeine therapy in preterm infants. Am J Dis Child 1990;144:1164 – 1166. 3. Lipsitz LA, Jansen RW, Connelly CM, Kelley-Gagnon MM, Parker AJ. Hae- modynamic and neurohumoral effects of caffeine in elderly patients with symp- tomatic postprandial hypotension: a double-blind, randomized, placebo-con- trolled study. Clin Sci 1994;87:259 – 267. 4. Zylber-Katz E, Granit L, Levy M. Relationship between caffeine concentra- tions in plasma and saliva. Clin Pharmacol Ther 1984;36:133 – 137. 5. American Hospital Formulary Service (AHFS) Drug Information. American Society of Health System Pharmacists: Bethesda. 1995;1566 – 1568. 6. Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of echocardiographic mea- surements. Circulation 1978;58:1072 – 1083. 7. Colan SD, Borow KM, Neumann A. Left ventricular end-systolic wall stress- velocity of fiber shortening relation: A load-independent index of myocardial contractility. Am J Cardiol 1984;4:715 – 724. 8. Friedman LR, Goldberg SJ, Donnerstein RL, Cardy MA, Palombo GM. Hemo- dynamic effects of acute ethanol in young adults. Am J Cardiol 1996;78:851–854. 9. Scholz H. Inotropic drugs and their mechanisms of action. J Am Coll Cardiol 1984;4:389 – 397. 10. Resch BA, Papp JG, Gynogyosi J. Effect of caffeine on the contractility of the fetal heart muscle. Zentralbl Gynakol 1987;109:945 – 951. 11. Pincomb GA, Lovallo WR, Passey RB, Whitsett TL, Silverstein SM, Wilson MF. Effects of caffeine on vascular resistance, cardiac output, and myocardial contractility in young men. Am J Cardiol 1985;56:119 – 122. Remodeling of Atherosclerotic Coronary Arteries Assessed With Intravascular Ultrasound In Vitro Elma J. Gussenhoven, MD, PhD, Jim H. Geselschap, MD, Winnifred van Lankeren, MD, David J. Posthuma, MSC, and Aad van der Lugt, MD, PhD FIGURE 1. Intravascular ultrasound cross sections obtained from atherosclerotic coronary arteries showing the target site (left panel) and the reference site (right panel). The inner contour pre- sents the lumen area and the outer contour the vessel area. The vessel area at the target site was larger (upper panel), in the same order (middle panel), and smaller (lower panel) than at the reference site. Calibration Å 1 mm; /Å catheter. T he present intravascular ultrasound study com- pares the analysis performed by Glagov et al 1 and subsequently adopted by others, 2–6 which deter- mined the relation between plaque and vessel areas obtained from a single histologic section per artery, with the analysis presented in later studies that com- pared the vessel area of the target lesion to an adja- cent reference segment. 6–8 jjj Atherosclerotic coronary arteries (n Å 47) were removed from humans at autopsy (n Å 22) or from explanted hearts that became available from patients referred for cardiac transplantation (n Å 25) (median age 51 years, range 26 to 65). The specimens (length ú4 cm) were stored frozen at 020°C. The investi- gation was approved by the local committee on hu- man research. For in vitro studies, the specimens were thawed. Side branches were tied off with su- tures and the ends were connected to sheaths fixed to a waterbath at room temperature. A reference point was indicated using a needle. During the study, the arteries were pressurized at 100 mm Hg by means of a fluid reservoir containing water connected to the side arm of the proximal sheath. For this study, cor- onary arteries were used with ¢30% area stenosis at the most stenotic site as seen with intravascular ul- trasound. From the University Hospital Rotterdam-Dijkzigt, Erasmus University Rotterdam, and the Interuniversity Cardiology Institute, The Nether- lands. This study was supported by grants 91.016 and 94.006 from the Interuniversity Cardiology Institute of the Netherlands and the Netherlands Heart Foundation, The Hague, The Netherlands. Dr. Gussenhoven’s address is: Erasmus University Rotterdam (Ee 2312) P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands. Manuscript received June 3, 1996; revised manuscript received and accepted September 16, 1996. A mechanical 30-MHz imaging system was used (DuMED, Rotterdam, The Netherlands). A displace- ment sensing device was used to document the dis-