Lipid-rich Plaques Detected by Near-infrared Spectroscopy Are More Frequently Exposed to High Shear Stress
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ORIGINAL ARTICLE
Lipid-rich Plaques Detected by Near-infrared Spectroscopy Are More Frequently Exposed to High Shear Stress Eline M. J. Hartman 1 & Giuseppe De Nisco 2 & Annette M. Kok 1 & Ayla Hoogendoorn 1 & Adriaan Coenen 3 & Frits Mastik 1 & Suze-Anne Korteland 1 & Koen Nieman 1,3,4 & Frank J. H. Gijsen 1 & Anton F. W. van der Steen 1 & Joost Daemen 1 & Jolanda J. Wentzel 1 Received: 19 April 2020 / Accepted: 14 September 2020 # The Author(s) 2020
Abstract High wall shear stress (WSS) and near-infrared spectroscopy (NIRS) detected lipid-rich plaque (LRP) are both known to be associated with plaque destabilization and future adverse cardiovascular events. However, knowledge of spatial co-localization of LRP and high WSS is lacking. This study investigated the co-localization of LRP based on NIRS and high WSS. Fifty-three patients presenting acute coronary syndrome underwent NIRS-intravascular-ultrasound (NIRS-IVUS) imaging of a non-culprit coronary artery. WSS was obtained using WSS profiling in 3D-reconstructions of the coronary arteries based on fusion of IVUSsegmented lumen and CT-derived 3D-centerline. Thirty-eight vessels were available for final analysis and divided into 0.5 mm/ 45° sectors. LRP sectors, as identified by NIRS, were more often colocalized with high WSS than sectors without LRP. Moreover, there was a dose-dependent relationship between lipid content and high WSS exposure. This study is a first step in understanding the evolution of LRPs to vulnerable plaques. Keywords Coronary artery disease . Near-infrared spectroscopy . Intravascular ultrasound . Wall shear stress . Vulnerable plaques . Lipid-rich plaques
List of abbreviations ACS Acute coronary syndrome CCTA Coronary computed tomography angiography CFD Computational fluid dynamics IQR Interquartile range Associate Editor Adrian Chester oversaw the review of this article Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12265-020-10072-x) contains supplementary material, which is available to authorized users.
IVUS LCBI LRP MaxLCBI4mm NIRS ROI PCI SD TAWSS WSS
Intravascular ultrasound Lipid core burden index Lipid-rich plaque 4 mm with the highest lipid core burden index in the region of interest Near-infrared spectroscopy Region of interest Percutaneous coronary intervention Standard deviation time-averaged wall shear stress Wall shear stress
* Jolanda J. Wentzel [email protected] 1
Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
2
PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
3
Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
4
Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
Introduction The underlying cause of most cardiovascular diseases is atherosclerosis, an inflammatory-driven disease associated with lipid accumulation in the vessel wall, resulting in plaque formation. The destabilization and rupture of an atherosclerotic plaque remain a leadin
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