Impact of coronary lumen reconstruction on the estimation of endothelial shear stress: in vivo comparison of three-dimensional quantitative coronary angiography and three-dimensional fusion combining optical coherent tomography. (25th September 2017)

• Record Type: Journal Article
• Authors: Kweon, Jihoon; Kang, Soo-Jin; Kim, Young-Hak; Lee, June-Goo; Han, Seungbong; Ha, Hojin; Yang, Dong Hyun; Kang, Joon-Won; Lim, Tae-Hwan; Kwon, Osung; Ahn, Jung-Min; Lee, Pil Hyung; Park, Duk-Woo; Lee, Seung-Whan; Lee, Cheol Whan; Park, Seong-Wook; Park, Seung-Jung
• Is Part Of: European heart journal. Volume 19:Number 10(2018)
• Page Start: 1134
• Page End: 1141
• Publication Date: 2017-09-25
• Subjects: atherosclerotic plaque -- coronary lumen reconstruction -- endothelial shear stress -- optical coherent tomography -- invasive coronary angiography; Cardiovascular system -- Imaging -- Periodicals; Heart -- Imaging -- Periodicals; 616.10754
• DOI: 10.1093/ehjci/jex222
• Languages: English
• ISSNs: 2047-2404

Abstract

Abstract: Aims: It is not clearly elucidated how the fusion technique improves the accuracy of endothelial shear stress (ESS) prediction, in comparison with that of three-dimensional (3D) quantitative coronary angiography (QCA) alone. We aimed to evaluate the difference in geometric measurements and haemodynamic estimation between 3D QCA and a 3D fusion model combining 3D QCA and optical coherence tomography (OCT). Methods and results: Computational fluid dynamics was assessed in the coronary models of 20 patients. In the plane-per-plane comparison, the difference and agreement were assessed using a generalized linear mixed model and concordance correlation coefficient (CCC), respectively. The haemodynamic feature around minimum-lumen-diameter (MLD) was characterized using CCC values calculated for 1-mm segments. In comparison with the 3D fusion model, 3D QCA showed a shorter maximum lumen diameter (2.54 ± 0.67 mm vs. 2.78 ± 0.73 mm, P < 0.001) and smaller lumen area (4.81 ± 2.56 mm 2 vs. 5.66 ± 2.97 mm 2, P < 0.001), resulting in a significantly higher ESS (4.64 Pa vs. 3.78 Pa, p = 0.029). A more asymmetric lumen shape of the 3D fusion model was more likely associated with under- and over-estimation of the maximum and minimum lumen diameters in the 3D QCA model, respectively. The circumferential ESS variations, which were blunted by 3D QCA, showed the worst concordance near the MLD site (CCC = 0.370) on segment-based comparison. Conclusion: The 3D fusion technique may be a more relevant tool for the haemodynamic simulation of coronary arteries through providing more accurate lumen characterization than 3D QCA.