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Influence of intracoronary hemodynamic forces on atherosclerotic plaque phenotypes.
Candreva, Alessandro; Gallo, Diego; Munhoz, Daniel; Rizzini, Maurizio Lodi; Mizukami, Takuya; Seki, Ruiko; Sakai, Koshiro; Sonck, Jeroen; Mazzi, Valentina; Ko, Brian; Nørgaard, Bjarne Linde; Jensen, Jesper Møller; Maeng, Michael; Otake, Hiromasa; Koo, Bon-Kwon; Shinke, Toshiro; Aben, Jean-Paul; Andreini, Daniele; Gallinoro, Emanuele; Stähli, Barbara E; Templin, Christian; Chiastra, Claudio; De Bruyne, Bernard; Morbiducci, Umberto; Collet, Carlos.
Afiliação
  • Candreva A; Department of Cardiology, Zurich University Hospital, Zurich, Switzerland; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
  • Gallo D; PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
  • Munhoz D; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy; Department of internal medicine, University of Campinas (Unicamp), Campinas, Brazil.
  • Rizzini ML; PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
  • Mizukami T; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, Showa University School of Medicine, Tokyo, Japan.
  • Seki R; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
  • Sakai K; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
  • Sonck J; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
  • Mazzi V; PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
  • Ko B; Monash Cardiovascular Research Centre, Monash University and Monash Heart, Monash Health, Clayton, Victoria, Australia.
  • Nørgaard BL; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Jensen JM; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Maeng M; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Otake H; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, Aichi Medical University, Aichi, Japan.
  • Koo BK; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea.
  • Shinke T; Department of Cardiology, Showa University School of Medicine, Tokyo, Japan.
  • Aben JP; Pie Medical Imaging BV, Maastricht, the Netherlands.
  • Andreini D; Department of Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy and Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
  • Gallinoro E; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy and Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
  • Stähli BE; Department of Cardiology, Zurich University Hospital, Zurich, Switzerland; University of Zurich, Zurich, Switzerland.
  • Templin C; Department of Cardiology, Zurich University Hospital, Zurich, Switzerland.
  • Chiastra C; PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
  • De Bruyne B; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
  • Morbiducci U; PoliTo(BIO) Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
  • Collet C; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium. Electronic address: carloscollet@gmail.com.
Int J Cardiol ; 399: 131668, 2024 Mar 15.
Article em En | MEDLINE | ID: mdl-38141723
ABSTRACT
BACKGROUND AND

AIMS:

Coronary hemodynamics impact coronary plaque progression and destabilization. The aim of the present study was to establish the association between focal vs. diffuse intracoronary pressure gradients and wall shear stress (WSS) patterns with atherosclerotic plaque composition.

METHODS:

Prospective, international, single-arm study of patients with chronic coronary syndromes and hemodynamic significant lesions (fractional flow reserve [FFR] ≤ 0.80). Motorized FFR pullback pressure gradient (PPG), optical coherence tomography (OCT), and time-average WSS (TAWSS) and topological shear variation index (TSVI) derived from three-dimensional angiography were obtained.

RESULTS:

One hundred five vessels (median FFR 0.70 [Interquartile range (IQR) 0.56-0.77]) had combined PPG and WSS analyses. TSVI was correlated with PPG (r = 0.47, [95% Confidence Interval (95% CI) 0.30-0.65], p < 0.001). Vessels with a focal CAD (PPG above the median value of 0.67) had significantly higher TAWSS (14.8 [IQR 8.6-24.3] vs. 7.03 [4.8-11.7] Pa, p < 0.001) and TSVI (163.9 [117.6-249.2] vs. 76.8 [23.1-140.9] m-1, p < 0.001). In the 51 vessels with baseline OCT, TSVI was associated with plaque rupture (OR 1.01 [1.00-1.02], p = 0.024), PPG with the extension of lipids (OR 7.78 [6.19-9.77], p = 0.003), with the presence of thin-cap fibroatheroma (OR 2.85 [1.11-7.83], p = 0.024) and plaque rupture (OR 4.94 [1.82 to 13.47], p = 0.002).

CONCLUSIONS:

Focal and diffuse coronary artery disease, defined using coronary physiology, are associated with differential WSS profiles. Pullback pressure gradients and WSS profiles are associated with atherosclerotic plaque phenotypes. Focal disease (as identified by high PPG) and high TSVI are associated with high-risk plaque features. CLINICAL TRIAL REGISTRATION https//clinicaltrials,gov/ct2/show/NCT03782688.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Reserva Fracionada de Fluxo Miocárdico / Placa Aterosclerótica Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Reserva Fracionada de Fluxo Miocárdico / Placa Aterosclerótica Idioma: En Ano de publicação: 2024 Tipo de documento: Article