Jonathan K. Tapley , Barry J. Doyle , Jamie W. Bellinge , Harrison T. Caddy , Dirk C. Blom , Thomas Churack , David E. Newby , Carl J. Schultz , Lachlan J. Kelsey
{"title":"低内皮剪切应力与急性冠脉综合征患者冠状动脉粥样硬化斑块活性增加有关。","authors":"Jonathan K. Tapley , Barry J. Doyle , Jamie W. Bellinge , Harrison T. Caddy , Dirk C. Blom , Thomas Churack , David E. Newby , Carl J. Schultz , Lachlan J. Kelsey","doi":"10.1016/j.jcct.2025.04.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Both coronary atherosclerotic plaque activity and low endothelial shear stress (ESS) are predictive of adverse cardiovascular events. We aimed to investigate their association and relationship with high-risk plaque features.</div></div><div><h3>Methods</h3><div><span><span>Coronary computed tomography angiography (CCTA) based flow simulations were used to compute ESS in patients presenting with </span>acute coronary syndrome proceeding percutaneous coronary intervention. Associations between ESS, CCTA plaque features and coronary plaque activity, measured by </span><sup>18</sup>F-sodium fluoride (<sup>18</sup><span>F–NaF) positron emission tomography (PET), were investigated at the coronary segment and vessel level.</span></div></div><div><h3>Results</h3><div>ESS and coronary plaque activity were both analyzed in 330 coronary segments and 123 vessels. The area of low ESS (<0.4 Pa), termed low shear area (LSA), was larger in <sup>18</sup>F–NaF positive regions increasing from median 11.7 mm<sup>2</sup> (IQR: 4.6–27.4) to 29.0 mm<sup>2</sup> (IQR: 14.1–55.2) at the segment level (<em>P</em> < 0.0001) and from median 27.3 mm<sup>2</sup> (IQR: 8.6–65.3) to 57.8 mm<sup>2</sup> (26.6–108.2) at the vessel level (<em>P</em> = 0.0049). The maximum tissue-to-background ratio of <sup>18</sup>F–NaF activity positively correlated with LSA at the segment level (<em>r</em><sub>s</sub> = 0.27; <em>P</em> < 0.0001) and at the vessel level (<em>r</em><sub>s</sub> = 0.38; <em>P</em> < 0.0001). LSA was associated with spotty calcification at both the segment (<em>P</em> <0.0001) and vessel level (<em>P</em> = 0.0042) and positive remodeling at the vessel level (<em>P</em> = 0.025).</div></div><div><h3>Conclusions</h3><div><span>In patients with acute coronary syndrome, LSA is associated with increased coronary atherosclerotic plaque activity, as measured by </span><sup>18</sup>F–NaF PET.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 4","pages":"Pages 455-463"},"PeriodicalIF":5.8000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Low endothelial shear stress is associated with increased coronary atherosclerotic plaque activity in patients that presented with acute coronary syndrome\",\"authors\":\"Jonathan K. Tapley , Barry J. Doyle , Jamie W. Bellinge , Harrison T. Caddy , Dirk C. Blom , Thomas Churack , David E. Newby , Carl J. Schultz , Lachlan J. Kelsey\",\"doi\":\"10.1016/j.jcct.2025.04.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Both coronary atherosclerotic plaque activity and low endothelial shear stress (ESS) are predictive of adverse cardiovascular events. We aimed to investigate their association and relationship with high-risk plaque features.</div></div><div><h3>Methods</h3><div><span><span>Coronary computed tomography angiography (CCTA) based flow simulations were used to compute ESS in patients presenting with </span>acute coronary syndrome proceeding percutaneous coronary intervention. Associations between ESS, CCTA plaque features and coronary plaque activity, measured by </span><sup>18</sup>F-sodium fluoride (<sup>18</sup><span>F–NaF) positron emission tomography (PET), were investigated at the coronary segment and vessel level.</span></div></div><div><h3>Results</h3><div>ESS and coronary plaque activity were both analyzed in 330 coronary segments and 123 vessels. The area of low ESS (<0.4 Pa), termed low shear area (LSA), was larger in <sup>18</sup>F–NaF positive regions increasing from median 11.7 mm<sup>2</sup> (IQR: 4.6–27.4) to 29.0 mm<sup>2</sup> (IQR: 14.1–55.2) at the segment level (<em>P</em> < 0.0001) and from median 27.3 mm<sup>2</sup> (IQR: 8.6–65.3) to 57.8 mm<sup>2</sup> (26.6–108.2) at the vessel level (<em>P</em> = 0.0049). The maximum tissue-to-background ratio of <sup>18</sup>F–NaF activity positively correlated with LSA at the segment level (<em>r</em><sub>s</sub> = 0.27; <em>P</em> < 0.0001) and at the vessel level (<em>r</em><sub>s</sub> = 0.38; <em>P</em> < 0.0001). LSA was associated with spotty calcification at both the segment (<em>P</em> <0.0001) and vessel level (<em>P</em> = 0.0042) and positive remodeling at the vessel level (<em>P</em> = 0.025).</div></div><div><h3>Conclusions</h3><div><span>In patients with acute coronary syndrome, LSA is associated with increased coronary atherosclerotic plaque activity, as measured by </span><sup>18</sup>F–NaF PET.</div></div>\",\"PeriodicalId\":49039,\"journal\":{\"name\":\"Journal of Cardiovascular Computed Tomography\",\"volume\":\"19 4\",\"pages\":\"Pages 455-463\"},\"PeriodicalIF\":5.8000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cardiovascular Computed Tomography\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1934592525000632\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular Computed Tomography","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1934592525000632","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Low endothelial shear stress is associated with increased coronary atherosclerotic plaque activity in patients that presented with acute coronary syndrome
Background
Both coronary atherosclerotic plaque activity and low endothelial shear stress (ESS) are predictive of adverse cardiovascular events. We aimed to investigate their association and relationship with high-risk plaque features.
Methods
Coronary computed tomography angiography (CCTA) based flow simulations were used to compute ESS in patients presenting with acute coronary syndrome proceeding percutaneous coronary intervention. Associations between ESS, CCTA plaque features and coronary plaque activity, measured by 18F-sodium fluoride (18F–NaF) positron emission tomography (PET), were investigated at the coronary segment and vessel level.
Results
ESS and coronary plaque activity were both analyzed in 330 coronary segments and 123 vessels. The area of low ESS (<0.4 Pa), termed low shear area (LSA), was larger in 18F–NaF positive regions increasing from median 11.7 mm2 (IQR: 4.6–27.4) to 29.0 mm2 (IQR: 14.1–55.2) at the segment level (P < 0.0001) and from median 27.3 mm2 (IQR: 8.6–65.3) to 57.8 mm2 (26.6–108.2) at the vessel level (P = 0.0049). The maximum tissue-to-background ratio of 18F–NaF activity positively correlated with LSA at the segment level (rs = 0.27; P < 0.0001) and at the vessel level (rs = 0.38; P < 0.0001). LSA was associated with spotty calcification at both the segment (P <0.0001) and vessel level (P = 0.0042) and positive remodeling at the vessel level (P = 0.025).
Conclusions
In patients with acute coronary syndrome, LSA is associated with increased coronary atherosclerotic plaque activity, as measured by 18F–NaF PET.
期刊介绍:
The Journal of Cardiovascular Computed Tomography is a unique peer-review journal that integrates the entire international cardiovascular CT community including cardiologist and radiologists, from basic to clinical academic researchers, to private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our cardiovascular imaging community across the world. The goal of the journal is to advance the field of cardiovascular CT as the leading cardiovascular CT journal, attracting seminal work in the field with rapid and timely dissemination in electronic and print media.