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01-09-2019 | Computed Tomography | Original Article

High shear stress on the coronary arterial wall is related to computed tomography-derived high-risk plaque: a three-dimensional computed tomography and color-coded tissue-characterizing intravascular ultrasonography study

Authors: Nobuhiro Murata, Takafumi Hiro, Tadateru Takayama, Suguru Migita, Tomoyuki Morikawa, Takehiro Tamaki, Takashi Mineki, Keisuke Kojima, Naotaka Akutsu, Mitsumasa Sudo, Daisuke Kitano, Daisuke Fukamachi, Atsushi Hirayama, Yasuo Okumura

Published in: Heart and Vessels | Issue 9/2019

Abstract

Low wall shear stress (WSS) is associated with plaque formation. However, the relationship between WSS and coronary plaque vulnerability remains unclear. Therefore, this study aimed to clarify the in vivo relationship between luminal WSS derived from three-dimensional (3D) computed tomography (CT) and plaque vulnerability within the coronary artery. Forty-three consecutive patients with ischemic heart disease and coronary stenotic lesions were enrolled and underwent coronary angiography and color-coded intravascular ultrasonography (iMap™) followed by multi-slice coronary CT angiography. CT-derived high-risk plaque was defined by specific CT characteristics, including low CT intensity (< 30 HU) and positive remodeling. The Student’s t test, Mann–Whitney U test, χ² test, repeated measures analysis of variance, and logistic and multiple regression were used for statistical analyses. CT-derived high-risk plaque (n = 15) had higher values of maximum and average shear stress than CT-derived stable plaque (474 ± 453 vs. 158 ± 138 Pa, p = 0.018; 4.2 ± 3.1 vs. 1.6 ± 1.2 Pa, p = 0.007, respectively). Compared with patients with CT-derived stable plaque, those with CT-derived high-risk plaque had a higher prevalence of necrotic and lipidic characteristics (44 ± 13 vs. 31 ± 11%, p = 0.001) based on iMap™. Multivariate logistic regression analysis showed that the average WSS and necrotic plus lipidic content were independent determinants of CT-derived high-risk plaque (average WSS: odds ratio 2.996, p = 0.014; necrotic plus lipidic content: odds ratio 1.306, p = 0.036). Our findings suggested that CT-derived high-risk plaque may coexist with high shear stress on the plaque surface.

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Title: High shear stress on the coronary arterial wall is related to computed tomography-derived high-risk plaque: a three-dimensional computed tomography and color-coded tissue-characterizing intravascular ultrasonography study
Authors: Nobuhiro Murata
Takafumi Hiro
Tadateru Takayama
Suguru Migita
Tomoyuki Morikawa
Takehiro Tamaki
Takashi Mineki
Keisuke Kojima
Naotaka Akutsu
Mitsumasa Sudo
Daisuke Kitano
Daisuke Fukamachi
Atsushi Hirayama
Yasuo Okumura
Publication date: 01-09-2019
Publisher: Springer Japan
Keywords: Computed Tomography
Computed Tomography
Acute Coronary Syndrome
CT Angiography
Arterial Occlusive Disease
Published in: Heart and Vessels / Issue 9/2019
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-019-01389-y

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