Intimal Thickening Sourced From Low Wall Shear Stress in Human Left Coronary Artery Was Observed by Optical Coherence Tomography

Author(s):  
Jin Suo ◽  
Michael McDaniel ◽  
Parham Eshtehardi ◽  
Saurabh S. Dhawan ◽  
Lucas H. Timmins ◽  
...  

The high resolution of optical coherence tomography (OCT) may offer improved description of luminal surfaces and intimal thickening in human coronary arteries by comparison to other imaging modalities, such as intravascular ultrasound (IVUS). We investigated the left anterior descending (LAD) coronary artery of a patient using both OCT and IVUS methods and found an asymmetrical distribution of intimal thickness (IT) around the lumen circumference in the OCT images, whereas the IVUS images showed a lumen with no asymmetry in IT. We reconstructed a 3D coronary artery model from the OCT slices that represented the morphological details of local luminal surfaces accurately and used this to simulate the pulsatile flow field in the model employing computational fluid dynamics (CFD). The pulsatile wall shear stress (WSS) distribution on the LAD surface was derived, and time-averaged WSS was computed. The data for IT and WSS distributions in the LAD segment were compared, and a linear inverse relationship between IT and WSS was found; higher WSS (> 25±5 dynes per square centimeter) favors thinner intima (< 0.12±0.05 millimeters) and lower WSS (< 12±5 dynes per square centimeter) favors thicker intima (> 0.33±0.05 millimeters). The enhanced spatial resolution of OCT offers an improved imaging technique for developing CFD models and assessing early atherosclerosis in patients with coronary artery disease.




2017 ◽  
Vol 14 (127) ◽  
pp. 20160972 ◽  
Author(s):  
Lucas H. Timmins ◽  
David S. Molony ◽  
Parham Eshtehardi ◽  
Michael C. McDaniel ◽  
John N. Oshinski ◽  
...  

Although experimental studies suggest that low and oscillatory wall shear stress (WSS) promotes plaque transformation to a more vulnerable phenotype, this relationship has not been examined in human atherosclerosis progression. Thus, the aim of this investigation was to examine the association between oscillatory WSS, in combination with WSS magnitude, and coronary atherosclerosis progression. We hypothesized that regions of low and oscillatory WSS will demonstrate progression towards more vulnerable lesions, while regions exposed to low and non-oscillatory WSS will exhibit progression towards more stable lesions. Patients ( n = 20) with non-flow-limiting coronary artery disease (CAD) underwent baseline and six-month follow-up angiography, Doppler velocity and radiofrequency intravascular ultrasound (VH-IVUS) acquisition. Computational fluid dynamics models were constructed to compute time-averaged WSS magnitude and oscillatory WSS. Changes in VH-IVUS-defined total plaque and constituent areas were quantified in focal regions (i.e. sectors; n = 14 235) and compared across haemodynamic categories. Compared with sectors exposed to low WSS magnitude, high WSS sectors demonstrated regression of total plaque area ( p < 0.001) and fibrous tissue ( p < 0.001), and similar progression of necrotic core. Sectors subjected to low and oscillatory WSS exhibited total plaque area regression, while low and non-oscillatory WSS sectors demonstrated total plaque progression ( p < 0.001). Furthermore, compared with low and non-oscillatory WSS areas, sectors exposed to low and oscillatory WSS demonstrated regression of fibrous ( p < 0.001) and fibrofatty ( p < 0.001) tissue and similar progression of necrotic core ( p = 0.82) and dense calcium ( p = 0.40). Herein, we demonstrate that, in patients with non-obstructive CAD, sectors subjected to low and oscillatory WSS demonstrated regression of total plaque, fibrous and fibrofatty tissue, and progression of necrotic core and dense calcium, which suggest a transformation to a more vulnerable phenotype.





2015 ◽  
Author(s):  
Zhenhe Ma ◽  
Shidan Dou ◽  
Yuqian Zhao ◽  
Yi Wang ◽  
Yanyan Suo ◽  
...  


Author(s):  
Lucas H. Timmins ◽  
Jin Suo ◽  
Parham Eshtehardi ◽  
Saurabh S. Dhawan ◽  
Michael C. McDaniel ◽  
...  

Myocardial infarction and sudden cardiac death are usually due to the rapid progression of previously non-flow limiting atherosclerotic plaques that transform to an unstable (i.e., vulnerable) phenotype. Despite considerable advances in medical therapies and treatment modalities for coronary artery disease (CAD), there is no accurate method to predict the site of abrupt lesion progression that can lead to an acute coronary event. Wall shear stress (WSS) has not only been implicated in the development of CAD, but also in its rapid progression [1]. Recent data from our laboratory indicates significant plaque progression in areas of low WSS (<10 dynes/cm2), plaque regression in regions of physiologic WSS (10–25 dynes/cm2), and phenotypic transformation towards an unstable lesion in regions of high WSS (>25 dynes/cm2) [2].



2013 ◽  
Vol 465-466 ◽  
pp. 789-795
Author(s):  
Muhamad Yunus ◽  
Anis Suhaila Shuib ◽  
Hasan Fawad

Wall Shear Stress (WSS) in the artery is one of the indicators for brain artery disease progression. WSS is proportional to the viscosity and shear rate of the flowing fluid. In this study, WSS of cerebral artery with aneurysm was predicted using Computational Fluid Dynamics (CFD). The effect of non-Newtonian properties of blood will be studied by comparing Power law model with Newtonian model. Based on the results, maximum value of WSS is 150 Pa for Newtonian model and for Power Law model is 24 Pa. Newtonian model was found overpredicted the WSS resulted from Power Law.



2018 ◽  
Vol 11 (20) ◽  
pp. 2072-2080 ◽  
Author(s):  
Arnav Kumar ◽  
Olivia Y. Hung ◽  
Marina Piccinelli ◽  
Parham Eshtehardi ◽  
Michel T. Corban ◽  
...  


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