Assessment of endothelial shear stress in patients with mild or intermediate coronary stenoses using coronary computed tomography angiography: comparison with invasive coronary angiography
Assessment of endothelial shear stress in patients with mild or intermediate coronary stenoses using coronary computed tomography angiography: comparison with invasive coronary angiography
复制标题
使用冠状动脉计算机断层扫描血管造影评估轻度或中度冠状动脉狭窄患者的内皮剪切应力：与侵入性冠状动脉造影的比较
DOI：
10.1007/s10554-016-1003-0
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发表时间：
2017-07-01
影响因子：
2.1
通讯作者：
Tu, Shengxian
中科院分区：
文献类型：
--
作者：
Huang, Dexiao;Muramatsu, Takashi;Tu, Shengxian
内皮剪切应力（ESS）的特征可以预测动脉粥样硬化的进展。本研究的目的是通过冠状动脉计算机断层扫描血管造影术（CTA）开发一种用于ESS体内评估的非侵入性方法，并将其与侵入性冠状动脉血管造影术（ICA）获得的ESS进行比较。共41例接受CTA和ICA的轻度或中度冠状动脉狭窄患者纳入分析。分别从CTA和ICA图像重建两个几何模型的查询血管。随后，应用计算流体动力学计算ESS，并由此分别推导出ESSCTA和ESSICA。在CTA和ICA模型中，对57支血管的163个节段进行了ESCTA和ESSICA之间的比较。ESSCTA和ESSICA相似：平均ESS：4.97（4.37 - 5.57）帕斯卡对4.86（4.27 - 5.44）帕斯卡，p = 0.58;最小ESS：0.86（0.67 - 1.05）帕斯卡对比0.79（0.63 - 0.95）帕斯卡，p = 0.37;最大ESS：14.50（12.62 - 16.38）帕斯卡对比13.76（11.44 - 16.08）帕斯卡，p = 0.44。ESS平均值（r = 0.75，p <0.001）、最小值（r = 0.61，p <0.001）和最大值（r = 0.62，p <0.001）的ESCTA和ESSICA之间存在良好的相关性。总之，CTA的几何重建在低和中等狭窄患者中基于节段的ESS计算方面产生与ICA相似的结果。因此，它有可能允许结合局部血流动力学和斑块形态学信息对冠状动脉疾病患者进行风险分层。
Characterization of endothelial shear stress (ESS) may allow for prediction of the progression of atherosclerosis. The aim of this investigation was to develop a non-invasive approach for in vivo assessment of ESS by coronary computed tomography angiography (CTA) and to compare it with ESS derived from invasive coronary angiography (ICA). A total of 41 patients with mild or intermediate coronary stenoses who underwent both CTA and ICA were included in the analysis. Two geometrical models of the interrogated vessels were reconstructed separately from CTA and ICA images. Subsequently, computational fluid dynamics were applied to calculate the ESS, from which ESSCTAand ESSICAwere derived, respectively. Comparisons between ESSCTAand ESSICAwere performed on 163 segments of 57 vessels in the CTA and ICA models. ESSCTAand ESSICAwere similar: mean ESS: 4.97 (4.37–5.57) Pascal versus 4.86 (4.27–5.44) Pascal,p= 0.58; minimal ESS: 0.86 (0.67–1.05) Pascal versus 0.79 (0.63–0.95) Pascal,p= 0.37; and maximal ESS: 14.50 (12.62–16.38) Pascal versus 13.76 (11.44–16.08) Pascal,p= 0.44. Good correlations between the ESSCTAand the ESSICAwere observed for the mean (r = 0.75,p< 0.001), minimal (r = 0.61,p< 0.001), and maximal (r = 0.62,p< 0.001) ESS values. In conclusion, geometrical reconstruction by CTA yields similar results to ICA in terms of segment-based ESS calculation in patients with low and intermediate stenoses. Thus, it has the potential of allowing combined local hemodynamic and plaque morphologic information for risk stratification in patients with coronary artery disease.