2 research outputs found
Relationship of Endothelial Shear Stress with Plaque Features with Coronary CT Angiography and Vasodilating Capability with PET
Background Advances in three-dimensional reconstruction techniques and computational fluid dynamics of coronary CT angiography (CCTA) data sets make feasible evaluation of endothelial shear stress (ESS) in the vessel wall. Purpose To investigate the relationship between CCTA-derived computational fluid dynamics metrics, anatomic and morphologic characteristics of coronary lesions, and their comparative performance in predicting impaired coronary vasodilating capability assessed by using PET myocardial perfusion imaging (MPI). Materials and Methods In this retrospective study, conducted between October 2019 and September 2020, coronary vessels in patients with stable chest pain and with intermediate probability of coronary artery disease who underwent both CCTA and PET MPI with oxygen 15-labeled water or nitrogen 13 ammonia and quantification of myocardial blood flow were analyzed. CCTA images were used in assessing stenosis severity, lesion-specific total plaque volume (PV), noncalcified PV, calcified PV, and plaque phenotype. PET MPI was used in assessing significant coronary stenosis. The predictive performance of the CCTA-derived parameters was evaluated by using area under the receiver operating characteristic curve (AUC) analysis. Results There were 92 coronary vessels evaluated in 53 patients (mean age, 65 years ± 7; 31 men). ESS was higher in lesions with greater than 50% stenosis versus those without significant stenosis (mean, 15.1 Pa ± 30 vs 4.6 Pa ± 4 vs 3.3 Pa ± 3; P = .004). ESS was higher in functionally significant versus nonsignificant lesions (median, 7 Pa [interquartile range, 5-23 Pa] vs 2.6 Pa [interquartile range, 1.8-5 Pa], respectively; P ≤ .001). Adding ESS to stenosis severity improved prediction (change in AUC, 0.10; 95% CI: 0.04, 0.17; P = .002) for functionally significant lesions. Conclusion The combination of endothelial shear stress with coronary CT angiography (CCTA) stenosis severity improved prediction of an abnormal PET myocardial perfusion imaging result versus CCTA stenosis severity alone. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Kusmirek and Wieben in this issue
Relationship of Endothelial Shear Stress with Plaque Features with Coronary CT Angiography and Vasodilating Capability with PET
Background: Advances in three-dimensional reconstruction techniques and
computational fluid dynamics of coronary CT angiography (CCTA) data sets
make feasible evaluation of endothelial shear stress (ESS) in the vessel
wall.
Purpose: To investigate the relationship between CCTA-derived
computational fluid dynamics metrics, anatomic and morphologic
characteristics of coronary lesions, and their comparative performance
in predicting impaired coronary vasodilating capability assessed by
using PET myocardial perfusion imaging (MPI).
Materials and Methods: In this retrospective study, conducted between
October 2019 and September 2020, coronary vessels in patients with
stable chest pain and with intermediate probability of coronary artery
disease who underwent both CCTA and PET MPI with oxygen 15-labeled water
or nitrogen 13 ammonia and quantification of myocardial blood flow were
analyzed. CCTA images were used in assessing stenosis severity,
lesion-specific total plaque volume (PV), noncalcified PV, calcified PV,
and plaque phenotype. PET MPI was used in assessing significant coronary
stenosis. The predictive performance of the CCTA-derived parameters was
evaluated by using area under the receiver operating characteristic
curve (AUC) analysis.
Results: There were 92 coronary vessels evaluated in 53 patients (mean
age, 65 years +/- 7; 31 men). ESS was higher in lesions with greater
than 50% stenosis versus those without significant stenosis (mean, 15.1
Pa +/- 30 vs 4.6 Pa +/- 4 vs 3.3 Pa +/- 3; P = .004). ESS was higher in
functionally significant versus nonsignificant lesions (median, 7 Pa
[interquartile range, 5-23 Pa] vs 2.6 Pa [interquartile range, 1.8-5
Pa], respectively; P <= .001). Adding ESS to stenosis severity improved
prediction (change in AUC, 0.10; 95% CI: 0.04, 0.17; P =.002) for
functionally significant lesions.
Conclusion: The combination of endothelial shear stress with coronary CT
angiography (CCTA) stenosis severity improved prediction of an abnormal
PET myocardial perfusion imaging result versus CCTA stenosis severity
alone. (C) RSNA, 202