Assessment of endothelial shear stress in patients with mild or intermediate coronary stenoses using coronary computed tomography angiography: comparison with invasive coronary angiography

Dexiao Huang, Takashi Muramatsu, Yingguang Li, Wenjie Yang, Yasuomi Nagahara, Miao Chu, Pieter Kitslaar, Masayoshi Sarai, Yukio Ozaki, Yiannis S. Chatzizisis, Fuhua Yan, Johan H.C. Reiber, Renhua Wu, Jun Pu, Shengxian Tu

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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 ESSCTA and ESSICA were derived, respectively. Comparisons between ESSCTA and ESSICA were performed on 163 segments of 57 vessels in the CTA and ICA models. ESSCTA and ESSICA were 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 ESSCTA and the ESSICA were 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.

Original languageEnglish (US)
Pages (from-to)1101-1110
Number of pages10
JournalInternational Journal of Cardiovascular Imaging
Volume33
Issue number7
DOIs
StatePublished - Jul 1 2017

Keywords

  • Computational fluid dynamics
  • Coronary computed tomography angiography
  • Endothelial shear stress
  • Invasive coronary angiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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