TY - JOUR
T1 - A novel four-dimensional angiographic approach to assess dynamic superficial wall stress of coronary arteries in vivo
T2 - Initial experience in evaluating vessel sites with subsequent plaque rupture
AU - Wu, Xinlei
AU - Von Birgelen, Clemens
AU - Muramatsu, Takashi
AU - Li, Yingguang
AU - Holm, Niels Ramsing
AU - Reiber, Johan H.C.
AU - Tu, Shengxian
N1 - Funding Information:
C. von Birgelen has received lecture fees from AstraZeneca; his institution has received research grants, provided by AstraZeneca, Biotronik, Boston Scientific, and Medtronic. Y. Li is an employee of Medis. N. Holm has received speaker fees from St. Jude Medical, Biotronik and Terumo, and institutional research grants from St. Jude Medical, Terumo, Boston Scientific, Medtronic, Biotronik, Medis and Cordis. J. Reiber is the CEO of Medis. S. Tu has received a research grant from Medis. The other authors have no conflicts of interest to declare.
Funding Information:
This work was supported by the National Key Research and Development Program of China (No. 2016YFC0100500) and the National Natural Science Foundation of China (No. 31500797 and 81570456).
Funding Information:
S. Tu acknowledges support by The Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learning (No. TP2015014) and the Shanghai Pujiang Program (No. 15PJ1404200).
Publisher Copyright:
© Europa Digital & Publishing 2017. All rights reserved.
PY - 2017/10
Y1 - 2017/10
N2 - Aims: Repetitive, fluctuating stress is an important biomechanical mechanism that underlies the rupture of atherosclerotic plaques. We developed a novel coronary angiography-based method for in vivo fourdimensional analysis of dynamic superficial wall stress (SWS) in coronary plaques and applied it for the first time in two clinical cases. Our aim was to investigate the potential relationship between dynamic stress concentration at baseline and plaque rupture during acute coronary syndrome (ACS) several months later. Methods and results: Three-dimensional angiographic reconstructions of the interrogated arteries were performed at several phases of the cardiac cycle, followed by finite element analysis to obtain the dynamic SWS data. The peak stress at baseline was found at the distal and proximal lesion longitudinal shoulders, being 121.8 kPa and 98.0 kPa, respectively. Intriguingly, in both cases, the sites with the highest SWS concentration at baseline co-registered with the location of plaque rupture during ACS, respectively six and 18 months after the baseline angiographic assessment. Conclusions: A novel angiography-based analysis method for four-dimensional evaluation of dynamic SWS was feasible for investigating plaque biomechanical behaviour in vivo. Initial experience suggests that this technique could be useful in exploring mechanisms of future plaque rupture.
AB - Aims: Repetitive, fluctuating stress is an important biomechanical mechanism that underlies the rupture of atherosclerotic plaques. We developed a novel coronary angiography-based method for in vivo fourdimensional analysis of dynamic superficial wall stress (SWS) in coronary plaques and applied it for the first time in two clinical cases. Our aim was to investigate the potential relationship between dynamic stress concentration at baseline and plaque rupture during acute coronary syndrome (ACS) several months later. Methods and results: Three-dimensional angiographic reconstructions of the interrogated arteries were performed at several phases of the cardiac cycle, followed by finite element analysis to obtain the dynamic SWS data. The peak stress at baseline was found at the distal and proximal lesion longitudinal shoulders, being 121.8 kPa and 98.0 kPa, respectively. Intriguingly, in both cases, the sites with the highest SWS concentration at baseline co-registered with the location of plaque rupture during ACS, respectively six and 18 months after the baseline angiographic assessment. Conclusions: A novel angiography-based analysis method for four-dimensional evaluation of dynamic SWS was feasible for investigating plaque biomechanical behaviour in vivo. Initial experience suggests that this technique could be useful in exploring mechanisms of future plaque rupture.
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U2 - 10.4244/EIJ-D-16-01020
DO - 10.4244/EIJ-D-16-01020
M3 - Article
C2 - 28262624
AN - SCOPUS:85021294704
VL - 13
SP - e1099-e1103
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 9
ER -