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Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of ‘shear stress score’
- Source :
- European Heart Journal - Cardiovascular Imaging. 18:888-897
- Publication Year :
- 2016
- Publisher :
- Oxford University Press (OUP), 2016.
-
Abstract
- 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 µm, 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.
- Subjects :
- Male
medicine.medical_specialty
Acute coronary syndrome
Endothelium
Coronary Artery Disease
030204 cardiovascular system & hematology
Risk Assessment
Severity of Illness Index
Vascular remodelling in the embryo
Coronary artery disease
03 medical and health sciences
Imaging, Three-Dimensional
0302 clinical medicine
Internal medicine
medicine
Shear stress
Humans
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Acute Coronary Syndrome
Aged
Observer Variation
Analysis of Variance
business.industry
Fibrous cap
Original Articles
General Medicine
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Plaque, Atherosclerotic
Surgery
Coronary arteries
Treatment Outcome
medicine.anatomical_structure
Cardiology
Female
Shear Strength
Cardiology and Cardiovascular Medicine
business
Tomography, Optical Coherence
Artery
Subjects
Details
- ISSN :
- 20472412 and 20472404
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- European Heart Journal - Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....f5bcc076596471fdc7f0cd657c81d6dc