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Implications of the local haemodynamic forces on the phenotype of coronary plaques
- Publication Year :
- 2019
- Publisher :
- BMJ Publishing Group, 2019.
-
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.
- 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
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....0da94d70b202fa23c7e38bcc5a508a8e
- Full Text :
- https://doi.org/10.7892/boris.128620