1. Relationship of Coronary Angiography-Derived Radial Wall Strain With Functional Significance, Plaque Morphology, and Clinical Outcomes.
- Author
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Yang, Seokhun, Wang, Zhiqing, Park, Sang-Hyeon, Hong, Huihong, Li, Chunming, Liu, Xun, Chen, Lianglong, Hwang, Doyeon, Zhang, Jinlong, Hoshino, Masahiro, Yonetsu, Taishi, Shin, Eun-Seok, Doh, Joon-Hyung, Nam, Chang-Wook, Wang, Jianan, Chen, Shaoliang, Tanaka, Nobuhiro, Matsuo, Hitoshi, Kubo, Takashi, and Chang, Hyuk-Jae
- Abstract
Coronary angiography-derived radial wall strain (RWS) is a newly developed index that can be readily accessed and describes the biomechanical features of a lesion. The authors sought to investigate the association of RWS with fractional flow reserve (FFR) and high-risk plaque (HRP), and their relative prognostic implications. We included 484 vessels (351 patients) deferred after FFR measurement with available RWS data and coronary computed tomography angiography. On coronary computed tomography angiography, HRP was defined as a lesion with both minimum lumen area <4 mm
2 and plaque burden ≥70%. The primary outcome was target vessel failure (TVF), a composite of target vessel revascularization, target vessel myocardial infarction, or cardiac death. The mean FFR and RWS max were 0.89 ± 0.07 and 11.2% ± 2.5%, respectively, whereas 27.7% of lesions had HRP, 15.1% had FFR ≤0.80. An increase in RWS max was associated with a higher risk of FFR ≤0.80 and HRP, which was consistent after adjustment for clinical or angiographic characteristics (all P < 0.05). An increment of RWS max was related to a higher risk of TVF (HR: 1.23 [95% CI: 1.03-1.47]; P = 0.022) with an optimal cutoff of 14.25%. RWS max >14% was a predictor of TVF after adjustment for FFR or HRP components (all P < 0.05) and showed a direct prognostic effect on TVF, not mediated by FFR ≤0.80 or HRP in the mediation analysis. When high RWS max was added to FFR ≤0.80 or HRP, there were increasing outcome trends (all P for trend <0.001). RWS was associated with coronary physiology and plaque morphology but showed independent prognostic significance. [Display omitted] [ABSTRACT FROM AUTHOR]- Published
- 2024
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