Coronary artery plaque rupture and erosion: Role of wall shear stress profiling and biological patterns in acute coronary syndromes. (1st January 2023)

• Record Type: Journal Article
• Authors: Russo, Giulio; Pedicino, Daniela; Chiastra, Claudio; Vinci, Ramona; Lodi Rizzini, Maurizio; Genuardi, Lorenzo; Sarraf, Mohammad; d'Aiello, Alessia; Bologna, Marco; Aurigemma, Cristina; Bonanni, Alice; Bellantoni, Antonio; D'Ascenzo, Fabrizio; Ciampi, Pellegrino; Zambrano, Aniello; Mainardi, Luca; Ponzo, Myriana; Severino, Anna; Trani, Carlo; Massetti, Massimo; Gallo, Diego; Migliavacca, Francesco; Maisano, Francesco; Lerman, Amir; Morbiducci, Umberto; Burzotta, Francesco; Crea, Filippo; Liuzzo, Giovanna
• Is Part Of: International journal of cardiology. Volume 370(2023)
• Page Start: 356
• Page End: 365
• Publication Date: 2023-01-01
• Subjects: Shear stress -- Vulnerable plaque -- Plaque rupture -- Plaque erosion -- Acute coronary syndrome -- Computational fluid dynamics -- Personalized medicine; ACS Acute Coronary Syndrome -- ADAMTS13 a disintegrin and metallopeptidase with thrombospondin type 1 motif 13 -- CCS Chronic Coronary Syndrome -- CFD Computational Fluid Dynamics -- EDN1 Endotelin-1 -- GPX1 Glutathione peroxidase 1 -- Hs CRP High-Sensitive C-Reactive Protein -- ICAM Intercellular Adhesion Molecule -- IFC Intact Fibrous Cap -- LGALS8 Galectin 8 -- MMPs Matrix metalloproteases -- NO Nitric oxide -- NOS3 Nitric oxide synthase3 -- NSTEMI Non-ST Elevation Myocardial Infarction -- OCT Optical Coherence Tomography -- PBMCs Peripheral Blood Mononuclear Cells -- PI16 Peptidase inhibitor 16 -- PLA1G7 Phospholipase A2 Group VII -- RFC Ruptured Fibrous Cap -- SOD1 Superoxide dismutase 1 -- TFRC Transferrin Receptor -- TIMP Tissue inhibitor of metalloproteinases 1 -- TNFα Tumor necrosis factor α -- VEGFA Vascular Endothelial Growth Factor A -- WSS Wall Shear Stress; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.10.139
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Aims: Wall shear stress (WSS) is involved in coronary artery plaque pathological mechanisms and modulation of gene expression. This study aims to provide a comprehensive haemodynamic and biological description of unstable (intact-fibrous-cap, IFC, and ruptured-fibrous-cap, RFC) and stable (chronic coronary syndrome, CCS) plaques and investigate any correlation between WSS and molecular pathways. Methods and results: We enrolled 24 CCS and 25 Non-ST Elevation Myocardial Infarction-ACS patients with IFC ( n = 11) and RFC ( n = 14) culprit lesions according to optical coherence tomography analysis. A real-time PCR primer array was performed on peripheral blood mononuclear cells for 17 different molecules whose expression is linked to WSS. Computational fluid dynamics simulations were performed in high-fidelity 3D-coronary artery anatomical models for three patients per group. A total of nine genes were significantly overexpressed in the unstable patients as compared to CCS patients, with no differences between IFC and RFC groups (GPX1, MMP1, MMP9, NOS3, PLA2G7, PI16, SOD1, TIMP1, and TFRC) while four displayed different levels between IFC and RFC groups (TNFα, ADAMTS13, EDN1, and LGALS8). A significantly higher WSS was observed in the RFC group ( p < 0.001) compared to the two other groups. A significant correlation was observed between TNFα (p < 0.001), EDN1 ( p = 0.036), and MMP9 ( p = 0.005) and WSS values in the RFC group. Conclusions: Our data demonstrate that IFC and RFC plaques are subject to different WSS conditions and gene expressions, suggesting that WSS profiling may play an essential role in the plaque instability characterization with relevant diagnostic and therapeutic implications in the era of precision medicine. Highlights: Wall shear stress (WSS) is involved in coronary artery plaque pathological mechanisms and modulation of gene expression. Different phenotypes of coronary artery plaques (intact fibrous cap and ruptured fibrous cap) are subject to different WSS and gene expression. The combination of fluid-dynamic with biological profiling might help to characterize coronary artery plaque and to detect unstable ones.