Coronary computed tomography angiography-based endothelial wall shear stress in normal coronary arteries
: Schultz Jussi, van den Hoogen Inge J, Kuneman Jurrien H, de Graaf Micihel A, Kamperidis Vasileios, Broersen Alexander, Jukema J Wouter, Sakellarios Antonis, Nikopoulos Sotirios, Tsarapatsani Konstantina, Naka Katerina, Michalis Lampros, Fotiadis Dimitrios I, Maaniitty Teemu, Saraste Antti , Bax Jeroen J, Knuuti Juhani
Publisher: SPRINGER
: 2023
: International Journal of Cardiovascular Imaging
: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
: INT J CARDIOVAS IMAG
: 10
: 1569-5794
: 1875-8312
DOI: https://doi.org/10.1007/s10554-022-02739-0
: https://doi.org/10.1007/s10554-022-02739-0
: https://research.utu.fi/converis/portal/detail/Publication/177251176
Endothelial wall shear stress (ESS) is a biomechanical force which plays a role in the formation and evolution of atherosclerotic lesions. The purpose of this study is to evaluate coronary computed tomography angiography (CCTA)-based ESS in coronary arteries without atherosclerosis, and to assess factors affecting ESS values. CCTA images from patients with suspected coronary artery disease were analyzed to identify coronary arteries without atherosclerosis. Minimal and maximal ESS values were calculated for 3-mm segments. Factors potentially affecting ESS values were examined, including sex, lumen diameter and distance from the ostium. Segments were categorized according to lumen diameter tertiles into small (< 2.6 mm), intermediate (2.6-3.2 mm) or large (>= 3.2 mm) segments. A total of 349 normal vessels from 168 patients (mean age 59 +/- 9 years, 39% men) were included. ESS was highest in the left anterior descending artery compared to the left circumflex artery and right coronary artery (minimal ESS 2.3 Pa vs. 1.9 Pa vs. 1.6 Pa, p < 0.001 and maximal ESS 3.7 Pa vs. 3.0 Pa vs. 2.5 Pa, p < 0.001). Men had lower ESS values than women, also after adjusting for lumen diameter (p < 0.001). ESS values were highest in small segments compared to intermediate or large segments (minimal ESS 3.8 Pa vs. 1.7 Pa vs. 1.2 Pa, p < 0.001 and maximal ESS 6.0 Pa vs. 2.6 Pa vs. 2.0 Pa, p < 0.001). A weak to strong correlation was found between ESS and distance from the ostium (rho = 0.22-0.62, p < 0.001). CCTA-based ESS values increase rapidly and become widely scattered with decreasing lumen diameter. This needs to be taken into account when assessing the added value of ESS beyond lumen diameter in highly stenotic lesions.
