Choosing the optimal wall shear parameter for the prediction of plaque location-A patient-specific computational study in human right coronary arteries
Choosing the optimal wall shear parameter for the prediction of plaque location-A patient-specific computational study in human right coronary arteries
复制标题
DOI：
10.1016/j.atherosclerosis.2010.03.001
复制
发表时间：
2010-08-01
期刊：
影响因子：
5.3
通讯作者：
Kurtcuoglu, Vartan
中科院分区：
文献类型：
--
作者：
Knight, Joseph;Olgac, Ufuk;Kurtcuoglu, Vartan
背景资料：平均壁剪切应力（AWSS）、平均壁剪切应力梯度（AWSSG）、振荡剪切指数（OSI）和相对停留时间（RRT）被认为是预测冠状动脉中易形成斑块的区域。我们的目的是分析动脉粥样硬化发生前患者血管中这些参数与此后特定斑块部位的相关性，并比较这些参数的敏感性和阳性预测值。方法：我们获得了30个患者特定的几何形状（平均年龄67.1（+/-9.2）岁，均患有稳定型心绞痛）的右冠状动脉（RCA），使用双源计算机断层扫描（CT），几乎去除了任何存在的斑块。然后我们进行计算流体动力学（CFD）模拟来计算壁面剪切参数。结果：对于120个总斑块，AWSS对斑块位置的预测平均具有更高的灵敏度（72 +/-25%），高于AWSSG（68 +/-36%），开放视察（60 +/-30%，p <0.05）和RRT（69 +/-59%）;而OSI的阳性预测值（PPV）（68 ± 34%）高于AWSS（47 ± 27%，p <0.001）、AWSSG（37 ± 23%，p <0.001）和RRT（59 ± 34%）。AWSSG和RRT之间PPV的差异也有显著性（p <0.01）。结论：当要使假阳性数最小化时，OSI和RRT是最佳参数。AWSS准确地识别了最大数量的斑块，但比OSI和RRT产生更多的假阳性。(C)2010爱思唯尔爱尔兰有限公司版权所有。
Background: Average wall shear-stress (AWSS), average wall shear-stress gradient (AWSSG), oscillatory shear index (OSI) and relative residence time (RRT) are believed to predict areas vulnerable to plaque formation in the coronary arteries. Our aim was to analyze the correlation of these parameters in patients' vessels before the onset of atherosclerosis to the specific plaque sites thereafter, and to compare the parameters' sensitivity and positive predictive value.Methods: We obtained 30 patient-specific geometries (mean age 67.1 (+/- 9.2) years, all with stable angina) of the right coronary artery (RCA) using dual-source computed tomography (CT) and virtually removed any plaque present. We then performed computational fluid dynamics (CFD) simulations to calculate the wall shear parameters.Results: For the 120 total plaques, AWSS had on average a higher sensitivity for the prediction of plaque locations (72 +/- 25%) than AWSSG (68 +/- 36%), OSI (60 +/- 30%, p < 0.05), and RRT (69 +/- 59%); while OSI had a higher positive predict value (PPV) (68 +/- 34%) than AWSS(47 +/- 27%, p < 0.001), AWSSG(37 +/- 23, p < 0.001) and RRT (59 +/- 34%). A significant difference was also found between AWSSG and RRT (p < 0.01) concerning PPV.Conclusions: OSI and RRT are the optimal parameters when the number of false positives is to be minimized. AWSS accurately identifies the largest number of plaques, but produces more false positives than OSI and RRT. (C) 2010 Elsevier Ireland Ltd. All rights reserved.