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Angiographic derived endothelial shear stress: a new predictor of atherosclerotic disease progression.

MedStar author(s):

2047-2404

Name of journal: European heart journal cardiovascular ImagingAbstract: Aims: To examine the efficacy of angiography derived endothelial shear stress (ESS) in predicting atherosclerotic disease progression.Conclusions: 3D QCA-derived ESS can predict disease progression. Further research is required to examine its value in detecting vulnerable plaques.Methods and results: Thirty-five patients admitted with ST-elevation myocardial infarction that had three-vessel intravascular ultrasound (IVUS) immediately after revascularization and at 13months follow-up were included. Three dimensional (3D) reconstruction of the non-culprit vessels were performed using (i) quantitative coronary angiography (QCA) and (ii) methodology involving fusion of IVUS and biplane angiography. In both models, blood flow simulation was performed and the minimum predominant ESS was estimated in 3mm segments. Baseline plaque characteristics and ESS were used to identify predictors of atherosclerotic disease progression defied as plaque area increase and lumen reduction at follow-up. Fifty-four vessels were included in the final analysis. A moderate correlation was noted between ESS estimated in the 3D QCA and the IVUS-derived models (r=0.588, P<0.001); 3D QCA accurately identified segments exposed to low (<1Pa) ESS in the IVUS-based reconstructions (AUC: 0.793, P<0.001). Low 3D QCA-derived ESS (<1.75Pa) was associated with an increase in plaque area, burden, and necrotic core at follow-up. In multivariate analysis, low ESS estimated either in 3D QCA [odds ratio (OR): 2.07, 95% confidence interval (CI): 1.17-3.67; P=0.012) or in IVUS (<1Pa; OR: 2.23, 95% CI: 1.23-4.03; P=0.008) models, and plaque burden were independent predictors of atherosclerotic disease progression; 3D QCA and IVUS-derived models had a similar accuracy in predicting disease progression (AUC: 0.826 vs. 0.827, P=0.907).All authors: Bourantas CV, Fotiadis DI, Garcia-Garcia HM, Karagiannis A, Koskinas K, Mathur A, Michalis LK, Raber L, Ramasamy A, Sakellarios A, Serruys PW, Shen X, Torii R, Ueki Y, Windecker S, Yamaji K, Zanchin TFiscal year: FY2019Digital Object Identifier:

https://dx.doi.org/10.1093/ehjci/jey091

Date added to catalog: 2018-07-30

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Title notes ( 4 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	30020435	Available		30020435

Aims: To examine the efficacy of angiography derived endothelial shear stress (ESS) in predicting atherosclerotic disease progression.

Conclusions: 3D QCA-derived ESS can predict disease progression. Further research is required to examine its value in detecting vulnerable plaques.

Methods and results: Thirty-five patients admitted with ST-elevation myocardial infarction that had three-vessel intravascular ultrasound (IVUS) immediately after revascularization and at 13months follow-up were included. Three dimensional (3D) reconstruction of the non-culprit vessels were performed using (i) quantitative coronary angiography (QCA) and (ii) methodology involving fusion of IVUS and biplane angiography. In both models, blood flow simulation was performed and the minimum predominant ESS was estimated in 3mm segments. Baseline plaque characteristics and ESS were used to identify predictors of atherosclerotic disease progression defied as plaque area increase and lumen reduction at follow-up. Fifty-four vessels were included in the final analysis. A moderate correlation was noted between ESS estimated in the 3D QCA and the IVUS-derived models (r=0.588, P<0.001); 3D QCA accurately identified segments exposed to low (<1Pa) ESS in the IVUS-based reconstructions (AUC: 0.793, P<0.001). Low 3D QCA-derived ESS (<1.75Pa) was associated with an increase in plaque area, burden, and necrotic core at follow-up. In multivariate analysis, low ESS estimated either in 3D QCA [odds ratio (OR): 2.07, 95% confidence interval (CI): 1.17-3.67; P=0.012) or in IVUS (<1Pa; OR: 2.23, 95% CI: 1.23-4.03; P=0.008) models, and plaque burden were independent predictors of atherosclerotic disease progression; 3D QCA and IVUS-derived models had a similar accuracy in predicting disease progression (AUC: 0.826 vs. 0.827, P=0.907).

English