The definition of low wall shear stress and its effect on plaque progression estimation in human coronary arteries.
The definition of low wall shear stress and its effect on plaque progression estimation in human coronary arteries.
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DOI：
10.1038/s41598-021-01232-3
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发表时间：
2021-11-11
影响因子：
4.6
通讯作者：
Wentzel JJ
中科院分区：
文献类型：
--
作者：
Hartman EMJ;De Nisco G;Gijsen FJH;Korteland SA;van der Steen AFW;Daemen J;Wentzel JJ
壁面剪切应力（WSS），即血液在血管壁上的摩擦力，在动脉粥样硬化斑块的形成中起着至关重要的作用。低WSS与斑块生长有关，但之前的研究使用不同的方法来定义低WSS，以研究其对斑块进展的影响。在这项研究中，我们使用四种方法在一个人类冠状动脉数据集中分配低、中、高WSS，并研究低WSS对斑块进展的预测能力。冠状动脉重建是基于多模态成像，使用血管内超声和ct成像。采用多普勒线测量血管特异性流量，并采用计算流体动力学方法计算WSS。冠状动脉间WSS绝对范围差异很大。在人群水平上，在所有定义WSS类别的方法中，低WSS时大多数斑块进展的既定模式都很明显。然而，对于单个患者，当使用测量流量来确定WSS时，绝对WSS值的范围太广，因此使用绝对阈值来确定低WSS并不适合用于确定斑块进展的高风险区域。
Wall shear stress (WSS), the frictional force of the blood on the vessel wall, plays a crucial role in atherosclerotic plaque development. Low WSS has been associated with plaque growth, however previous research used different approaches to define low WSS to investigate its effect on plaque progression. In this study, we used four methodologies to allocate low, mid and high WSS in one dataset of human coronary arteries and investigated the predictive power of low WSS for plaque progression. Coronary reconstructions were based on multimodality imaging, using intravascular ultrasound and CT-imaging. Vessel-specific flow was measured using Doppler wire and computational fluid dynamics was performed to calculate WSS. The absolute WSS range varied greatly between the coronary arteries. On the population level, the established pattern of most plaque progression at low WSS was apparent in all methodologies defining the WSS categories. However, for the individual patient, when using measured flow to determine WSS, the absolute WSS values range so widely, that the use of absolute thresholds to determine low WSS was not appropriate to identify regions at high risk for plaque progression.
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