High endothelial shear stress and stress gradient at plaque erosion persist up to 12 months. (15th June 2022)

• Record Type: Journal Article
• Authors: Kim, Hyung Oh.; Jiang, Bo; Poon, Eric K.W.; Thondapu, Vikas; Kim, Chong-Jin; Kurihara, Osamu; Araki, Makoto; Nakajima, Akihiro; Mamon, Chris; Dijkstra, Jouke; Lee, Hang; Ooi, Andrew; Barlis, Peter; Jang, Ik-Kyung
• Is Part Of: International journal of cardiology. Volume 357(2022)
• Page Start: 1
• Page End: 7
• Publication Date: 2022-06-15
• Subjects: Computational fluid dynamics -- Endothelial shear stress -- Endothelial shear stress gradient -- Optical coherence tomography -- Plaque erosion; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.03.035
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Local hemodynamics are known to play an important role in the development of plaque erosion. Recent studies showed that erosion patients might be treated conservatively without stent implantation. We investigated evolution of hemodynamic parameters on the plaque erosion site in conservatively treated patients. Methods: Computational fluid dynamics (CFD) simulations were performed using the coronary angiogram and optical coherence tomography (OCT) images of non-stent treated erosion patients who had serial OCT studies. Calculated CFD parameters included endothelial shear stress (ESS), ESS gradient (ESSG), and oscillatory shear index (OSI). Results: The CFD parameters at the erosion and non-erosion sites were compared among baseline ( n = 23), and 1-month ( n = 20) and 12-month ( n = 16) follow-ups. The erosion site had higher ESS and ESSG values than the non-erosion sites at baseline (mean ESS: 3.00 vs 1.36 Pa, p < 0.01; mean ESSG: 1.71 vs. 0.65 Pa/mm, p = 0.01), 1-month (mean ESS: 2.89 vs 1.19 Pa, p < 0.01; mean ESSG: 1.71 vs. 0.60 Pa/mm, p < 0.01), and 12-month (mean ESS: 3.26 vs 1.59 Pa, p < 0.01; mean ESSG: 1.87 vs. 0.78 Pa/mm, p < 0.01). OSI was not different between erosion and and non-erosion sites. Conclusions: ESS and ESSG values were higher at the plaque erosion sites compared to non-erosion sites. Elevated ESS and ESSG at the erosion site persisted up to 12 months. These data indicate that a local thrombogenic milieu related to hemodynamic perturbation persists up to 12 months at the plaque erosion sites following conservative treatment. Clinical Trial Registration: https://clinicaltrials.gov : NCT02041650 Highlights: Endothelial shear stress (ESS) and ESS gradient were elevated at erosion sites. Elevated ESS and ESS gradient at the erosion sites persisted up to 12 months. Hemodynamically thrombogenic milieu at erosion site persists up to 12 months. Prolonged antiplatelet therapy may be important in non-stented erosion patients.