A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä

Detailed behaviour of endothelial wall shear stress across coronary lesions from non-invasive imaging with coronary computed tomography angiography




Tekijätvan den Hoogen Inge J., Schultz Jussi, Kuneman Jurrien H., de Graaf Michiel A., Kamperidis Vasileios, Broersen Alexander, Jukema J. Wouter, Sakellarios Antonis, Nikopoulos Sotirios, Kyriakidis Savvas, Naka Katerina K., Michalis Lampros, Fotiadis Dimitrios I., Maaniitty Teemu, Saraste Antti, Bax Jeroen J., Knuuti Juhani

KustantajaOXFORD UNIV PRESS

Julkaisuvuosi2022

JournalEHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging

Lehden akronyymiEUR HEART J-CARD IMG

Vuosikerta23

Numero12

Aloitussivu1708

Lopetussivu1716

Sivujen määrä9

ISSN2047-2404

eISSN2047-2412

DOIhttps://doi.org/10.1093/ehjci/jeac095

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/175634340


Tiivistelmä

Aims Evolving evidence suggests that endothelial wall shear stress (ESS) plays a crucial role in the rupture and progression of coronary plaques by triggering biological signalling pathways. We aimed to investigate the patterns of ESS across coronary lesions from non-invasive imaging with coronary computed tomography angiography (CCTA), and to define plaque-associated ESS values in patients with coronary artery disease (CAD).

Methods and results Symptomatic patients with CAD who underwent a clinically indicated CCTA scan were identified. Separate core laboratories performed blinded analysis of CCTA for anatomical and ESS features of coronary atherosclerosis. ESS was assessed using dedicated software, providing minimal and maximal ESS values for each 3 mm segment. Each coronary lesion was divided into upstream, start, minimal luminal area (MLA), end and downstream segments. Also, ESS ratios were calculated using the upstream segment as a reference. From 122 patients (mean age 64 +/- 7 years, 57% men), a total of 237 lesions were analyzed. Minimal and maximal ESS values varied across the lesions with the highest values at the MLA segment [minimal ESS 3.97 Pa (IQR 1.93-8.92 Pa) and maximal ESS 5.64 Pa (IQR 3.13-11.21 Pa), respectively]. Furthermore, minimal and maximal ESS values were positively associated with stenosis severity (P < 0.001), percent atheroma volume (P < 0.001), and lesion length (P <= 0.023) at the MLA segment. Using ESS ratios, similar associations were observed for stenosis severity and lesion length.

Conclusions Detailed behaviour of ESS across coronary lesions can be derived from routine non-invasive CCTA imaging. This may further improve risk stratification.


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