P3588The synergistic effect of NIRS-detected lipid-rich plaque and 5 different multidirectional wall shear stress metrics on human coronary plaque growth

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E M J Hartman ◽  
A M Kok ◽  
A Hoogendoorn ◽  
F J H Gijsen ◽  
A F W Steen ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Synergistic Effect ◽  
Coronary Arteries ◽  
Wall Thickness ◽  
Plaque Progression ◽  
Lipid Rich Plaque ◽  
Plaque Growth ◽  
Wall Shear ◽  
The Impact

Abstract Introduction Local wall shear stress (WSS) metrics, high local lipid levels (as detected by near-infrared spectroscopy (NIRS)), as well as systemic lipid levels, have been individually associated with atherosclerotic disease progression. However, a possible synergistic effect remains to be elucidated. This study is the first study to combine WSS metrics with NIRS-detected local lipid content to investigate a potential synergistic effect on plaque progression in human coronary arteries. Methods The IMPACT study is a prospective, single centre study investigating the relation between atherosclerotic plaque progression and WSS in human coronary arteries. Patients with ACS treated with PCI were included. At baseline and after 1-year follow-up, patients underwent near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) imaging and intravascular doppler flow measurements of at least one non-culprit coronary artery. After one month, a CT angiography was made. CT derived centreline combined with IVUS lumen contours resulted in a 3D reconstruction of the vessel. The following WSS metrics were computed using computational fluid dynamics applying the vessel specific invasive flow measurements: time-average wall shear stress (TAWSS), relative residence time (RRT), cross-flow index, oscillatory shear index and transverse wall shear stress. Low TAWSS is known as pro atherogenic, in contrast to all the other shear stress metrics, at which a high magnitude is pro-atherogenic. The arteries were divided into 1.5mm/45° sectors. Based on NIRS-IVUS, wall thickness change over time was determined and NIRS positive sectors detected. Furthermore, per vessel the shear stress was divided into tertiles (low, intermediate, high). To investigate the synergistic effect of local lipids on shear stress related plaque growth, wall thickness change over time was related to the different shear stress metrics comparing the NIRS-positive with the NIRS-negative sectors. Results 15 non-culprit coronary arteries from the first 14 patients were analyzed (age 62±10 years old and 92.9% male). A total of 2219 sectors were studied (5.2%, N=130, NIRS-positive) for wall thickness changes. After studying all five shear stress metrics, we found for TAWSS and RRT that presence of lipids, as detected by NIRS, amplified the effect of shear stress on plaque progression (see figure). Sectors presenting with lipid-rich plaque, compared to NIRS-negative sectors, showed more progression when they were exposed to low TAWSS (p=0.07) or high RRT (p=0.012) and more regression in sectors exposed to high TAWSS (p=0.10) or low RRT (p=0.06). Delta wall thickness vs shear stress Conclusion We presented the first preliminary results of the IMPACT study, showing the synergistic effect of lipid rich plaque and shear stress on plaque progression. Therefore, intravascular lipid-rich plaque (NIRS) assessment has added value to shear stress profiling for the prediction of plaque growth, leading to improved risk stratification. Acknowledgement/Funding ERC starting grant 310457

scholarly journals THE SYNERGISTIC EFFECT OF NIRS-DETECTED LIPID-RICH PLAQUE AND WALL SHEAR STRESS ON HUMAN CORONARY PLAQUE GROWTH

2020 ◽  
Vol 75 (11) ◽  
pp. 1391
Author(s):  
Jolanda Wentzel ◽  
Eline M. Hartman ◽  
Giuseppe De Nisco ◽  
Ayla Hoogendoorn ◽  
Annette Kok ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Synergistic Effect ◽  
Coronary Plaque ◽  
Lipid Rich Plaque ◽  
Plaque Growth ◽  
Wall Shear

scholarly journals An assessment of intra-patient variability on observed relationships between wall shear stress and plaque progression in coronary arteries

2015 ◽  
Vol 14 (Suppl 1) ◽  
pp. S2 ◽  
Author(s):  
David S Molony ◽  
Lucas H Timmins ◽  
Olivia Y Hung ◽  
Emad Rasoul-Arzrumly ◽  
Habib Samady ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Coronary Arteries ◽  
Plaque Progression ◽  
Wall Shear

Negative Correlation of Wall Thickness With Wall Blood Pressure in a Patient-Specific Atherosclerotic Coronary Artery: A Case Report

2012 ◽  
Author(s):  
Biyue Liu ◽  
Jie Zheng ◽  
Richard Bach ◽  
Dalin Tang
Keyword(s):  
Blood Pressure ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Wall Thickness ◽  
Patient Specific ◽  
Artery Wall ◽  
Atherosclerosis Progression ◽  
Wall Shear ◽  
Intensive Investigation ◽  
The Impact

There are two major hemodynamic stresses imposed at the blood-arterial wall interface by flowing blood: the wall shear stress (WSS) acting tangentially to the wall, and the wall pressure (WP) acting vertically to the wall. These forces influence the artery wall metabolism and correspond to the local modifications of artery wall thickness, composition, microarchitecture, and compliance [2]. The role of flow wall shear stress in atherosclerosis progression has been under intensive investigation [4], while the impact of local blood pressure on plaque progression has been under-studied.

scholarly journals The definition of low wall shear stress and its effect on plaque progression estimation in human coronary arteries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eline M. J. Hartman ◽  
Giuseppe De Nisco ◽  
Frank J. H. Gijsen ◽  
Suze-Anne Korteland ◽  
Anton F. W. van der Steen ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Coronary Arteries ◽  
Multimodality Imaging ◽  
Population Level ◽  
Plaque Progression ◽  
Specific Flow ◽  
The Absolute ◽  
Wall Shear ◽  
The Individual

AbstractWall shear stress (WSS), the frictional force of the blood on the vessel wall, plays a crucial role in atherosclerotic plaque development. Low WSS has been associated with plaque growth, however previous research used different approaches to define low WSS to investigate its effect on plaque progression. In this study, we used four methodologies to allocate low, mid and high WSS in one dataset of human coronary arteries and investigated the predictive power of low WSS for plaque progression. Coronary reconstructions were based on multimodality imaging, using intravascular ultrasound and CT-imaging. Vessel-specific flow was measured using Doppler wire and computational fluid dynamics was performed to calculate WSS. The absolute WSS range varied greatly between the coronary arteries. On the population level, the established pattern of most plaque progression at low WSS was apparent in all methodologies defining the WSS categories. However, for the individual patient, when using measured flow to determine WSS, the absolute WSS values range so widely, that the use of absolute thresholds to determine low WSS was not appropriate to identify regions at high risk for plaque progression.

Exploring wall shear stress spatiotemporal heterogeneity in coronary arteries combining correlation-based analysis and complex networks with computational hemodynamics

2020 ◽  
Vol 234 (11) ◽  
pp. 1209-1222 ◽  
Author(s):  
Karol Calò ◽  
Giuseppe De Nisco ◽  
Diego Gallo ◽  
Claudio Chiastra ◽  
Ayla Hoogendoorn ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Complex Networks ◽  
Coronary Arteries ◽  
Early Stage ◽  
Flow Direction ◽  
Computational Hemodynamics ◽  
Time Histories ◽  
Wall Shear

Atherosclerosis at the early stage in coronary arteries has been associated with low cycle-average wall shear stress magnitude. However, parallel to the identification of an established active role for low wall shear stress in the onset/progression of the atherosclerotic disease, a weak association between lesions localization and low/oscillatory wall shear stress has been observed. In the attempt to fully identify the wall shear stress phenotype triggering early atherosclerosis in coronary arteries, this exploratory study aims at enriching the characterization of wall shear stress emerging features combining correlation-based analysis and complex networks theory with computational hemodynamics. The final goal is the characterization of the spatiotemporal and topological heterogeneity of wall shear stress waveforms along the cardiac cycle. In detail, here time-histories of wall shear stress magnitude and wall shear stress projection along the main flow direction and orthogonal to it (a measure of wall shear stress multidirectionality) are analyzed in a representative dataset of 10 left anterior descending pig coronary artery computational hemodynamics models. Among the main findings, we report that the proposed analysis quantitatively demonstrates that the model-specific inlet flow-rate shapes wall shear stress time-histories. Moreover, it emerges that a combined effect of low wall shear stress magnitude and of the shape of the wall shear stress–based descriptors time-histories could trigger atherosclerosis at its earliest stage. The findings of this work suggest for new experiments to provide a clearer determination of the wall shear stress phenotype which is at the basis of the so-called arterial hemodynamic risk hypothesis in coronary arteries.

scholarly journals Fusion of fibrous cap thickness and wall shear stress to assess plaque vulnerability in coronary arteries: a pilot study

2016 ◽  
Vol 11 (10) ◽  
pp. 1779-1790 ◽  
Author(s):  
Guillaume Zahnd ◽  
Jelle Schrauwen ◽  
Antonios Karanasos ◽  
Evelyn Regar ◽  
Wiro Niessen ◽  
...  
Keyword(s):  
Shear Stress ◽  
Pilot Study ◽  
Wall Shear Stress ◽  
Coronary Arteries ◽  
Plaque Vulnerability ◽  
Fibrous Cap ◽  
Wall Shear ◽  
Fibrous Cap Thickness

scholarly journals Temporal and spatial changes in wall shear stress during atherosclerotic plaque progression in mice

2018 ◽  
Vol 5 (3) ◽  
pp. 171447 ◽  
Author(s):  
R. Xing ◽  
A. M. Moerman ◽  
Y. Ridwan ◽  
M. J. Daemen ◽  
A. F. W. van der Steen ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Mouse Model ◽  
Atherosclerotic Plaque ◽  
Proximal Part ◽  
Plaque Progression ◽  
Plaque Composition ◽  
Spatial Changes ◽  
Temporal And Spatial ◽  
Wall Shear

Wall shear stress (WSS) is involved in atherosclerotic plaque initiation, yet its role in plaque progression remains unclear. We aimed to study (i) the temporal and spatial changes in WSS over a growing plaque and (ii) the correlation between WSS and plaque composition, using animal-specific data in an atherosclerotic mouse model. Tapered casts were placed around the right common carotid arteries (RCCA) of ApoE −/− mice. At 5, 7 and 9 weeks after cast placement, RCCA geometry was reconstructed using contrast-enhanced micro-CT. Lumen narrowing was observed in all mice, indicating the progression of a lumen intruding plaque. Next, we determined the flow rate in the RCCA of each mouse using Doppler Ultrasound and computed WSS at all time points. Over time, as the plaque developed and further intruded into the lumen, absolute WSS significantly decreased. Finally at week 9, plaque composition was histologically characterized. The proximal part of the plaque was small and eccentric, exposed to relatively lower WSS. Close to the cast a larger and concentric plaque was present, exposed to relatively higher WSS. Lower WSS was significantly correlated to the accumulation of macrophages in the eccentric plaque. When pooling data of all animals, correlation between WSS and plaque composition was weak and no longer statistically significant. In conclusion, our data showed that in our mouse model absolute WSS strikingly decreased during disease progression, which was significantly correlated to plaque area and macrophage content. Besides, our study demonstrates the necessity to analyse individual animals and plaques when studying correlations between WSS and plaque composition.

scholarly journals Hemodynamic parameters and vessel tortuosity: an investigation with a mesenterial vascular network

2017 ◽  
Vol 1 (4) ◽  
pp. 62-68
Author(s):  
Roberto Annunziata ◽  
Bettina Reglin ◽  
Axel Pries ◽  
Emanuele Trucco
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Oxygen Saturation ◽  
Wall Thickness ◽  
Blood Velocity ◽  
Vascular Network ◽  
Hemodynamic Parameters ◽  
Vessel Tortuosity ◽  
Wall Shear ◽  
Quantitative Definition

Purpose: The effect of hemodynamic parameters on vessel tortuosity remains un-clear. Here we investigate the correlation of tortuosity with a set of hemodynamicparameters in a mesenterial vascular network.Methods: A mesenterial vascular network of 389 vessels (131 arteries, 132 veins, and 126 capillaries) was imaged. Eleven hemodynamic parameters were measured (pressure, wall shear stress, diameter, blood velocity and flow, viscosity, haematocrit, partial oxygen saturation, oxygen saturation, wall thickness, and local vessel density). Tortuosity was assessed quantitatively with a validated algorithm and correlation computed with subsets of hemodynamic parameters selected by a lasso regressor.Results: Results suggest that tortuosity is related to pressure, wall shear stress, diameter, blood velocity, viscosity, partial but not full oxygen saturation, and wall thickness for the arteries; diameter, blood flow, hematocrit, and density for the veins; and viscosity (but not hematocrit), partial and full oxygen saturation, and density for the capillaries. The combination of hemodynamic parameters correlating best with tortuosity is the set of all parameters except density (r = 0.64, p < 0.01), using as tortuosity definition the set of tortuosity features (geometric measures) correlating best with a single hemodynamic factor for the arteries.Conclusion: This pilot suggests two general conclusions. First, the quantitative definition of tortuosity (i.e., the set of geometric features adopted) should be tuned to the specific data and problem considered. Second, tortuosity is caused by a combination of hemodynamic factors, not a single one.

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