1. Implications of the local haemodynamic forces on the phenotype of coronary plaques
- Author
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Masanori Taniwaki, Thomas Zanchin, Aris Moschovitis, Dimitrios I. Fotiadis, Lampros Mihalis, Ryo Torii, Alexios Karagiannis, Antonis I. Sakellarios, Hector M. Garcia-Garcia, Christos V Bourantas, Kyohei Yamaji, Dik Heg, Stephan Windecker, Lorenz Räber, Anantharaman Ramasamy, Patrick W. Serruys, and Andreas Baumbach
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Myocardial Infarction ,Lumen (anatomy) ,Hemodynamics ,Coronary Artery Disease ,Multimodal Imaging ,Coronary artery disease ,Percutaneous Coronary Intervention ,medicine ,Humans ,Plaque morphology ,Myocardial infarction ,610 Medicine & health ,Ultrasonography, Interventional ,business.industry ,Disease progression ,Middle Aged ,medicine.disease ,Coronary Vessels ,Phenotype ,Plaque, Atherosclerotic ,Dimensional Measurement Accuracy ,Regional Blood Flow ,Disease Progression ,Mixed effects ,Female ,Endothelium, Vascular ,Shear Strength ,Cardiology and Cardiovascular Medicine ,business ,Tomography, Optical Coherence ,360 Social problems & social services - Abstract
AimTo examine the effect of endothelial shear stress (ESS) on the dynamic changes in plaque phenotype.MethodsPatients with myocardial infarction that had intravascular ultrasound-virtual histology (IVUS-VH) and optical coherence tomography (OCT) at baseline and 13-month follow-up were studied. The IVUS-VH data were used to reconstruct the nonculprit vessels, and in the obtained models the ESS was estimated in 3 mm segments. Plaque morphology was derived in each segment from IVUS-VH and OCT. Disease progression was defined as the presence of ≥2 out of the following criteria: reduction in lumen area, increase in plaque burden and change of plaque morphology to a more vulnerable phenotype. Linear mixed effects models were used to assess the effect of ESS in different phenotypes.ResultsSixty-eight vessels were included in the analysis. Low ESS was associated with plaque progression in all phenotypes. The effect of ESS on plaque burden (p for interaction=0.467) and phenotype (p for interaction=0.188) was similar in all plaque types, whereas the effect of ESS on the changes in lumen dimensions was more prominent in disease-free (β=0.70, pConclusionsThe effect of ESS on plaque progression is similar in all phenotypes and cannot be accurately assessed by standalone IVUS-VH which often misclassifies plaque morphology. Therefore, multimodality imaging should be considered to examine the implications of ESS on plaque evolution.Clinical trial registrationNCT00962416; Post-results.
- Published
- 2019
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