Header

UZH-Logo

Maintenance Infos

Implications of the local hemodynamic forces on the formation and destabilization of neoatherosclerotic lesions


Torii, Ryo; Stettler, Rodrigue; Räber, Lorenz; Zhang, Yao-Jun; Karanasos, Antonis; Dijkstra, Jouke; Patel, Kush; Crake, Tom; Hamshere, Steve; Garcia-Garcia, Hector M; Tenekecioglu, Erhan; Ozkor, Muhiddin; Baumbach, Andreas; Windecker, Stephan; Serruys, Patrick W; Regar, Evelyn; Mathur, Anthony; Bourantas, Christos V (2018). Implications of the local hemodynamic forces on the formation and destabilization of neoatherosclerotic lesions. International Journal of Cardiology, 272:7-12.

Abstract

OBJECTIVE
To examine the implications of endothelial shear stress (ESS) distribution in the formation of neoatherosclerotic lesions.
METHODS
Thirty six patients with neoatherosclerotic lesions on optical coherence tomography (OCT) were included in this study. The OCT data were used to reconstruct coronary anatomy. Blood flow simulation was performed in the models reconstructed from the stent borders which it was assumed that represented the lumen surface at baseline, immediate after stent implantation, and the estimated ESS was associated with the neointima burden, neoatherosclerotic burden and neointima characteristics. In segments with neointima rupture blood flow simulation was also performed in the model representing the lumen surface before rupture and the ESS was estimated at the ruptured site.
RESULTS
An inverse association was noted between baseline ESS and the incidence and the burden of neoatherosclerotic (β = -0.60, P < 0.001, and β = -4.05, P < 0.001, respectively) and lipid-rich neoatherosclerotic tissue (β = -0.54, P < 0.001, and β = -3.60, P < 0.001, respectively). Segments exposed to low ESS (<1 Pa) were more likely to exhibit macrophages accumulation (28.2% vs 10.9%, P < 0.001), thrombus (11.0% vs 2.6%, P < 0.001) and evidence of neointima discontinuities (8.1% vs 0.9%, P < 0.001) compared to those exposed to normal or high ESS. In segments with neointima rupture the ESS was high at the rupture site compared to the average ESS over the culprit lesion (4.00 ± 3.65 Pa vs 3.14 ± 2.90 Pa, P < 0.001).
CONCLUSIONS
Local EES is associated with neoatherosclerotic lesion characteristics, which suggests involvement of ESS in the formation of vulnerable plaques in stented segments.

Abstract

OBJECTIVE
To examine the implications of endothelial shear stress (ESS) distribution in the formation of neoatherosclerotic lesions.
METHODS
Thirty six patients with neoatherosclerotic lesions on optical coherence tomography (OCT) were included in this study. The OCT data were used to reconstruct coronary anatomy. Blood flow simulation was performed in the models reconstructed from the stent borders which it was assumed that represented the lumen surface at baseline, immediate after stent implantation, and the estimated ESS was associated with the neointima burden, neoatherosclerotic burden and neointima characteristics. In segments with neointima rupture blood flow simulation was also performed in the model representing the lumen surface before rupture and the ESS was estimated at the ruptured site.
RESULTS
An inverse association was noted between baseline ESS and the incidence and the burden of neoatherosclerotic (β = -0.60, P < 0.001, and β = -4.05, P < 0.001, respectively) and lipid-rich neoatherosclerotic tissue (β = -0.54, P < 0.001, and β = -3.60, P < 0.001, respectively). Segments exposed to low ESS (<1 Pa) were more likely to exhibit macrophages accumulation (28.2% vs 10.9%, P < 0.001), thrombus (11.0% vs 2.6%, P < 0.001) and evidence of neointima discontinuities (8.1% vs 0.9%, P < 0.001) compared to those exposed to normal or high ESS. In segments with neointima rupture the ESS was high at the rupture site compared to the average ESS over the culprit lesion (4.00 ± 3.65 Pa vs 3.14 ± 2.90 Pa, P < 0.001).
CONCLUSIONS
Local EES is associated with neoatherosclerotic lesion characteristics, which suggests involvement of ESS in the formation of vulnerable plaques in stented segments.

Statistics

Citations

Dimensions.ai Metrics
8 citations in Web of Science®
7 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiac Surgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Cardiology and Cardiovascular Medicine
Uncontrolled Keywords:Endothelial shear stress Neoatherosclerosis Optical coherence tomography
Language:English
Date:1 December 2018
Deposited On:22 Feb 2019 09:31
Last Modified:29 Jul 2020 09:37
Publisher:Elsevier
ISSN:0167-5273
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.ijcard.2018.06.065
PubMed ID:30293579

Download

Full text not available from this repository.
View at publisher

Get full-text in a library