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Multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics
AIMS: Atherosclerotic plaque development has been associated with wall shear stress (WSS). However, the multidirectionality of blood flow, and thus of WSS, is rarely taken into account. The purpose of this study was to comprehensively compare five metrics that describe (multidirectional) WSS behavio...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177495/ https://www.ncbi.nlm.nih.gov/pubmed/31504238 http://dx.doi.org/10.1093/cvr/cvz212 |
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author | Hoogendoorn, Ayla Kok, Annette M Hartman, Eline M J de Nisco, Giuseppe Casadonte, Lorena Chiastra, Claudio Coenen, Adriaan Korteland, Suze-Anne Van der Heiden, Kim Gijsen, Frank J H Duncker, Dirk J van der Steen, Antonius F W Wentzel, Jolanda J |
author_facet | Hoogendoorn, Ayla Kok, Annette M Hartman, Eline M J de Nisco, Giuseppe Casadonte, Lorena Chiastra, Claudio Coenen, Adriaan Korteland, Suze-Anne Van der Heiden, Kim Gijsen, Frank J H Duncker, Dirk J van der Steen, Antonius F W Wentzel, Jolanda J |
author_sort | Hoogendoorn, Ayla |
collection | PubMed |
description | AIMS: Atherosclerotic plaque development has been associated with wall shear stress (WSS). However, the multidirectionality of blood flow, and thus of WSS, is rarely taken into account. The purpose of this study was to comprehensively compare five metrics that describe (multidirectional) WSS behaviour and assess how WSS multidirectionality affects coronary plaque initiation and progression. METHODS AND RESULTS: Adult familial hypercholesterolaemic pigs (n = 10) that were fed a high-fat diet, underwent imaging of the three main coronary arteries at three-time points [3 (T(1)), 9 (T(2)), and 10–12 (T(3)) months]. Three-dimensional geometry of the arterial lumen, in combination with local flow velocity measurements, was used to calculate WSS at T(1) and T(2). For analysis, arteries were divided into 3 mm/45° sectors (n = 3648). Changes in wall thickness and final plaque composition were assessed with near-infrared spectroscopy–intravascular ultrasound, optical coherence tomography imaging, and histology. Both in pigs with advanced and mild disease, the highest plaque progression rate was exclusively found at low time-averaged WSS (TAWSS) or high multidirectional WSS regions at both T(1) and T(2). However, the eventually largest plaque growth was located in regions with initial low TAWSS or high multidirectional WSS that, over time, became exposed to high TAWSS or low multidirectional WSS at T(2). Besides plaque size, also the presence of vulnerable plaque components at the last time point was related to low and multidirectional WSS. Almost all WSS metrics had good predictive values for the development of plaque (47–50%) and advanced fibrous cap atheroma (FCA) development (59–61%). CONCLUSION: This study demonstrates that low and multidirectional WSS promote both initiation and progression of coronary atherosclerotic plaques. The high-predictive values of the multidirectional WSS metrics for FCA development indicate their potential as an additional clinical marker for the vulnerable disease. |
format | Online Article Text |
id | pubmed-7177495 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-71774952020-04-28 Multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics Hoogendoorn, Ayla Kok, Annette M Hartman, Eline M J de Nisco, Giuseppe Casadonte, Lorena Chiastra, Claudio Coenen, Adriaan Korteland, Suze-Anne Van der Heiden, Kim Gijsen, Frank J H Duncker, Dirk J van der Steen, Antonius F W Wentzel, Jolanda J Cardiovasc Res Original Articles AIMS: Atherosclerotic plaque development has been associated with wall shear stress (WSS). However, the multidirectionality of blood flow, and thus of WSS, is rarely taken into account. The purpose of this study was to comprehensively compare five metrics that describe (multidirectional) WSS behaviour and assess how WSS multidirectionality affects coronary plaque initiation and progression. METHODS AND RESULTS: Adult familial hypercholesterolaemic pigs (n = 10) that were fed a high-fat diet, underwent imaging of the three main coronary arteries at three-time points [3 (T(1)), 9 (T(2)), and 10–12 (T(3)) months]. Three-dimensional geometry of the arterial lumen, in combination with local flow velocity measurements, was used to calculate WSS at T(1) and T(2). For analysis, arteries were divided into 3 mm/45° sectors (n = 3648). Changes in wall thickness and final plaque composition were assessed with near-infrared spectroscopy–intravascular ultrasound, optical coherence tomography imaging, and histology. Both in pigs with advanced and mild disease, the highest plaque progression rate was exclusively found at low time-averaged WSS (TAWSS) or high multidirectional WSS regions at both T(1) and T(2). However, the eventually largest plaque growth was located in regions with initial low TAWSS or high multidirectional WSS that, over time, became exposed to high TAWSS or low multidirectional WSS at T(2). Besides plaque size, also the presence of vulnerable plaque components at the last time point was related to low and multidirectional WSS. Almost all WSS metrics had good predictive values for the development of plaque (47–50%) and advanced fibrous cap atheroma (FCA) development (59–61%). CONCLUSION: This study demonstrates that low and multidirectional WSS promote both initiation and progression of coronary atherosclerotic plaques. The high-predictive values of the multidirectional WSS metrics for FCA development indicate their potential as an additional clinical marker for the vulnerable disease. Oxford University Press 2020-05-01 2019-08-22 /pmc/articles/PMC7177495/ /pubmed/31504238 http://dx.doi.org/10.1093/cvr/cvz212 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Articles Hoogendoorn, Ayla Kok, Annette M Hartman, Eline M J de Nisco, Giuseppe Casadonte, Lorena Chiastra, Claudio Coenen, Adriaan Korteland, Suze-Anne Van der Heiden, Kim Gijsen, Frank J H Duncker, Dirk J van der Steen, Antonius F W Wentzel, Jolanda J Multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics |
title | Multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics |
title_full | Multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics |
title_fullStr | Multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics |
title_full_unstemmed | Multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics |
title_short | Multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics |
title_sort | multidirectional wall shear stress promotes advanced coronary plaque development: comparing five shear stress metrics |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177495/ https://www.ncbi.nlm.nih.gov/pubmed/31504238 http://dx.doi.org/10.1093/cvr/cvz212 |
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