A novel four-dimensional angiographic approach to assess dynamic superficial wall stress of coronary arteries in vivo: Initial experience in evaluating vessel sites with subsequent plaque rupture

Xinlei Wu, Clemens von Birgelen, Takashi Muramatsu, Yingguang Li, Niels Ramsing Holm, Johan H.C. Reiber, Shengxian Tu*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
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Abstract

Aims: Repetitive, fluctuating stress is an important biomechanical mechanism that underlies the rupture of atherosclerotic plaques. We developed a novel coronary angiography-based method for in vivo fourdimensional analysis of dynamic superficial wall stress (SWS) in coronary plaques and applied it for the first time in two clinical cases. Our aim was to investigate the potential relationship between dynamic stress concentration at baseline and plaque rupture during acute coronary syndrome (ACS) several months later.

Methods and results: Three-dimensional angiographic reconstructions of the interrogated arteries were performed at several phases of the cardiac cycle, followed by finite element analysis to obtain the dynamic SWS data. The peak stress at baseline was found at the distal and proximal lesion longitudinal shoulders, being 121.8 kPa and 98.0 kPa, respectively. Intriguingly, in both cases, the sites with the highest SWS concentration at baseline co-registered with the location of plaque rupture during ACS, respectively six and 18 months after the baseline angiographic assessment.

Conclusions: A novel angiography-based analysis method for four-dimensional evaluation of dynamic SWS was feasible for investigating plaque biomechanical behaviour in vivo. Initial experience suggests that this technique could be useful in exploring mechanisms of future plaque rupture.

Original languageEnglish
Pages (from-to)e1099-e1103
JournalEuroIntervention
Volume13
Issue number9
DOIs
Publication statusPublished - 13 Oct 2017

Fingerprint

Rupture
Coronary Vessels
Acute Coronary Syndrome
Finite Element Analysis
Atherosclerotic Plaques
Coronary Angiography
Angiography
Arteries

Keywords

  • Acute coronary syndrome
  • Dynamic superficial wall stress
  • Optical coherence tomography
  • Plaque rupture

Cite this

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title = "A novel four-dimensional angiographic approach to assess dynamic superficial wall stress of coronary arteries in vivo: Initial experience in evaluating vessel sites with subsequent plaque rupture",
abstract = "Aims: Repetitive, fluctuating stress is an important biomechanical mechanism that underlies the rupture of atherosclerotic plaques. We developed a novel coronary angiography-based method for in vivo fourdimensional analysis of dynamic superficial wall stress (SWS) in coronary plaques and applied it for the first time in two clinical cases. Our aim was to investigate the potential relationship between dynamic stress concentration at baseline and plaque rupture during acute coronary syndrome (ACS) several months later.Methods and results: Three-dimensional angiographic reconstructions of the interrogated arteries were performed at several phases of the cardiac cycle, followed by finite element analysis to obtain the dynamic SWS data. The peak stress at baseline was found at the distal and proximal lesion longitudinal shoulders, being 121.8 kPa and 98.0 kPa, respectively. Intriguingly, in both cases, the sites with the highest SWS concentration at baseline co-registered with the location of plaque rupture during ACS, respectively six and 18 months after the baseline angiographic assessment.Conclusions: A novel angiography-based analysis method for four-dimensional evaluation of dynamic SWS was feasible for investigating plaque biomechanical behaviour in vivo. Initial experience suggests that this technique could be useful in exploring mechanisms of future plaque rupture.",
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author = "Xinlei Wu and {von Birgelen}, Clemens and Takashi Muramatsu and Yingguang Li and Holm, {Niels Ramsing} and Reiber, {Johan H.C.} and Shengxian Tu",
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A novel four-dimensional angiographic approach to assess dynamic superficial wall stress of coronary arteries in vivo : Initial experience in evaluating vessel sites with subsequent plaque rupture. / Wu, Xinlei; von Birgelen, Clemens; Muramatsu, Takashi; Li, Yingguang; Holm, Niels Ramsing; Reiber, Johan H.C.; Tu, Shengxian.

In: EuroIntervention, Vol. 13, No. 9, 13.10.2017, p. e1099-e1103.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Wu, Xinlei

AU - von Birgelen, Clemens

AU - Muramatsu, Takashi

AU - Li, Yingguang

AU - Holm, Niels Ramsing

AU - Reiber, Johan H.C.

AU - Tu, Shengxian

PY - 2017/10/13

Y1 - 2017/10/13

N2 - Aims: Repetitive, fluctuating stress is an important biomechanical mechanism that underlies the rupture of atherosclerotic plaques. We developed a novel coronary angiography-based method for in vivo fourdimensional analysis of dynamic superficial wall stress (SWS) in coronary plaques and applied it for the first time in two clinical cases. Our aim was to investigate the potential relationship between dynamic stress concentration at baseline and plaque rupture during acute coronary syndrome (ACS) several months later.Methods and results: Three-dimensional angiographic reconstructions of the interrogated arteries were performed at several phases of the cardiac cycle, followed by finite element analysis to obtain the dynamic SWS data. The peak stress at baseline was found at the distal and proximal lesion longitudinal shoulders, being 121.8 kPa and 98.0 kPa, respectively. Intriguingly, in both cases, the sites with the highest SWS concentration at baseline co-registered with the location of plaque rupture during ACS, respectively six and 18 months after the baseline angiographic assessment.Conclusions: A novel angiography-based analysis method for four-dimensional evaluation of dynamic SWS was feasible for investigating plaque biomechanical behaviour in vivo. Initial experience suggests that this technique could be useful in exploring mechanisms of future plaque rupture.

AB - Aims: Repetitive, fluctuating stress is an important biomechanical mechanism that underlies the rupture of atherosclerotic plaques. We developed a novel coronary angiography-based method for in vivo fourdimensional analysis of dynamic superficial wall stress (SWS) in coronary plaques and applied it for the first time in two clinical cases. Our aim was to investigate the potential relationship between dynamic stress concentration at baseline and plaque rupture during acute coronary syndrome (ACS) several months later.Methods and results: Three-dimensional angiographic reconstructions of the interrogated arteries were performed at several phases of the cardiac cycle, followed by finite element analysis to obtain the dynamic SWS data. The peak stress at baseline was found at the distal and proximal lesion longitudinal shoulders, being 121.8 kPa and 98.0 kPa, respectively. Intriguingly, in both cases, the sites with the highest SWS concentration at baseline co-registered with the location of plaque rupture during ACS, respectively six and 18 months after the baseline angiographic assessment.Conclusions: A novel angiography-based analysis method for four-dimensional evaluation of dynamic SWS was feasible for investigating plaque biomechanical behaviour in vivo. Initial experience suggests that this technique could be useful in exploring mechanisms of future plaque rupture.

KW - Acute coronary syndrome

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