3 research outputs found
Recommended from our members
Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of 'shear stress score'.
AimsThe 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 resultsA 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.ConclusionLocal 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
Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of 'shear stress score'
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
Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of `shear stress score'
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