High shear stress on the coronary arterial wall is related to computed tomography-derived high-risk plaque: a three-dimensional computed tomography and ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-11

AUTHORS

Nobuhiro Murata, Takafumi Hiro, Tadateru Takayama, Suguru Migita, Tomoyuki Morikawa, Takehiro Tamaki, Takashi Mineki, Keisuke Kojima, Naotaka Akutsu, Mitsumasa Sudo, Daisuke Kitano, Daisuke Fukamachi, Atsushi Hirayama, Yasuo Okumura

ABSTRACT

Low wall shear stress (WSS) is associated with plaque formation. However, the relationship between WSS and coronary plaque vulnerability remains unclear. Therefore, this study aimed to clarify the in vivo relationship between luminal WSS derived from three-dimensional (3D) computed tomography (CT) and plaque vulnerability within the coronary artery. Forty-three consecutive patients with ischemic heart disease and coronary stenotic lesions were enrolled and underwent coronary angiography and color-coded intravascular ultrasonography (iMap™) followed by multi-slice coronary CT angiography. CT-derived high-risk plaque was defined by specific CT characteristics, including low CT intensity (< 30 HU) and positive remodeling. The Student's t test, Mann-Whitney U test, χ2 test, repeated measures analysis of variance, and logistic and multiple regression were used for statistical analyses. CT-derived high-risk plaque (n = 15) had higher values of maximum and average shear stress than CT-derived stable plaque (474 ± 453 vs. 158 ± 138 Pa, p = 0.018; 4.2 ± 3.1 vs. 1.6 ± 1.2 Pa, p = 0.007, respectively). Compared with patients with CT-derived stable plaque, those with CT-derived high-risk plaque had a higher prevalence of necrotic and lipidic characteristics (44 ± 13 vs. 31 ± 11%, p = 0.001) based on iMap™. Multivariate logistic regression analysis showed that the average WSS and necrotic plus lipidic content were independent determinants of CT-derived high-risk plaque (average WSS: odds ratio 2.996, p = 0.014; necrotic plus lipidic content: odds ratio 1.306, p = 0.036). Our findings suggested that CT-derived high-risk plaque may coexist with high shear stress on the plaque surface. More... »

Journal

TITLE

Heart and Vessels

ISSUE

N/A

VOLUME

N/A

Author Affiliations

From Grant

  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00380-019-01389-y

    DOI

    http://dx.doi.org/10.1007/s00380-019-01389-y

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1113378519

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30976923


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