TY  - BOOK
AU  - Garcia-Garcia, Hector M
TI  - Implications of the local haemodynamic forces on the phenotype of coronary plaques
SN  - 1355-6037
PY  - 2019///
KW  - *Coronary Vessels
KW  - *Endothelium, Vascular
KW  - *Myocardial Infarction
KW  - *Plaque, Atherosclerotic
KW  - *Regional Blood Flow
KW  - *Tomography, Optical Coherence/mt [Methods]
KW  - *Ultrasonography, Interventional/mt [Methods]
KW  - Coronary Artery Disease/di [Diagnosis]
KW  - Coronary Artery Disease/pp [Physiopathology]
KW  - Coronary Artery Disease/th [Therapy]
KW  - Coronary Vessels/dg [Diagnostic Imaging]
KW  - Coronary Vessels/pp [Physiopathology]
KW  - Dimensional Measurement Accuracy
KW  - Disease Progression
KW  - Endothelium, Vascular/pa [Pathology]
KW  - Endothelium, Vascular/pp [Physiopathology]
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Multimodal Imaging
KW  - Myocardial Infarction/di [Diagnosis]
KW  - Myocardial Infarction/et [Etiology]
KW  - Myocardial Infarction/su [Surgery]
KW  - Percutaneous Coronary Intervention/is [Instrumentation]
KW  - Percutaneous Coronary Intervention/mt [Methods]
KW  - Plaque, Atherosclerotic/co [Complications]
KW  - Plaque, Atherosclerotic/dg [Diagnostic Imaging]
KW  - Plaque, Atherosclerotic/pp [Physiopathology]
KW  - Shear Strength/ph [Physiology]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 1939 - present, Available in print through MWHC library: 1996 - 2006
N2  - AIM: To examine the effect of endothelial shear stress (ESS) on the dynamic changes in plaque phenotype; CLINICAL TRIAL REGISTRATION: NCT00962416; Post-results. Copyright (c) Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ; CONCLUSIONS: The effect of ESS on plaque progression is similar in all phenotypes and cannot be accurately assessed by standalone IVUS-VH which often misclassifies plaque morphology. Therefore, multimodality imaging should be considered to examine the implications of ESS on plaque evolution; METHODS: Patients with myocardial infarction that had intravascular ultrasound-virtual histology (IVUS-VH) and optical coherence tomography (OCT) at baseline and 13-month follow-up were studied. The IVUS-VH data were used to reconstruct the nonculprit vessels, and in the obtained models the ESS was estimated in 3 mm segments. Plaque morphology was derived in each segment from IVUS-VH and OCT. Disease progression was defined as the presence of >=2 out of the following criteria: reduction in lumen area, increase in plaque burden and change of plaque morphology to a more vulnerable phenotype. Linear mixed effects models were used to assess the effect of ESS in different phenotypes; RESULTS: Sixty-eight vessels were included in the analysis. Low ESS was associated with plaque progression in all phenotypes. The effect of ESS on plaque burden (p for interaction=0.467) and phenotype (p for interaction=0.188) was similar in all plaque types, whereas the effect of ESS on the changes in lumen dimensions was more prominent in disease-free (beta=0.70, p<0.001) than fibrotic/fibrocalcific (beta=0.28, p<0.001) or lipid-rich plaques (beta=0.15, p=0.015). Standalone IVUS-VH misclassified plaque morphology in one-third of the cases leading to erroneous estimations about the effect of ESS on plaque evolution in different phenotypes
UR  - https://dx.doi.org/10.1136/heartjnl-2018-314086
ER  -