Τίτλος:
Association of global and local low endothelial shear stress with
high-risk plaque using intracoronary 3D optical coherence tomography:
Introduction of `shear stress score'
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aims The association of low endothelial shear stress (ESS) with
high-risk plaque (HRP) has not been thoroughly investigated in humans.
We investigated the local ESS and lumen remodelling patterns in HRPs
using optical coherence tomography (OCT), developed the shear stress
score, and explored its association with the prevalence of HRPs and
clinical outcomes.
Methods and results A total of 35 coronary arteries from 30 patients
with stable angina or acute coronary syndrome (ACS) were reconstructed
with three dimensional (3D) OCT. ESS was calculated using computational
fluid dynamics and classified into low, moderate, and high in 3-mm-long
subsegments. In each subsegment, (i) fibroatheromas (FAs) were
classified into HRPs and non-HRPs based on fibrous cap (FC) thickness
and lipid pool size, and (ii) lumen remodelling was classified into
constrictive, compensatory, and expansive. In each artery the shear
stress score was calculated as metric of the extent and severity of low
ESS. FAs in low ESS subsegments had thinner FC compared with high ESS
(89 +/- 84 vs. 138 +/- 83 mu m, P, 0.05). Low ESS subsegments
predominantly co-localized with HRPs vs. non-HRPs (29 vs. 9%, P, 0.05)
and high ESS subsegments predominantly with non-HRPs (9 vs. 24%, P,
0.05). Compensatory and expansive lumen remodelling were the predominant
responses within subsegments with low ESS and HRPs. In non-stenotic FAs,
low ESS was associated with HRPs vs. non-HRPs (29 vs. 3%, P, 0.05).
Arteries with increased shear stress score had increased frequency of
HRPs and were associated with ACS vs. stable angina.
Conclusion Local low ESS and expansive lumen remodelling are associated
with HRP. Arteries with increased shear stress score have increased
frequency of HRPs and propensity to present with ACS.
Συγγραφείς:
Chatzizisis, Yiannis S.
Toutouzas, Konstantinos
Giannopoulos,
Andreas A.
Riga, Maria
Antoniadis, Antonios P.
Fujinom,
Yusuke
Mitsouras, Dimitrios
Koutkias, Vassilis G. and
Cheimariotis, Grigorios
Doulaverakis, Charalampos and
Tsampoulatidis, Ioannis
Chouvarda, Ioanna
Kompatsiaris, Ioannis
and Nakamura, Sunao
Rybicki, Frank J.
Maglaveras, Nicos and
Tousoulis, Dimitris
Giannoglou, George D.
Περιοδικό:
European Heart Journal - Cardiovascular Imaging
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
coronary artery disease; optical coherence tomography; high-risk plaque;
endothelial shear stress; shear stress score; vascular remodelling;
clinical events
DOI:
10.1093/ehjci/jew134
