Expert recommendations on the assessment of wall shear stress in human coronary arteries: existing methodologies, technical considerations, and clinical applications

Gijsen, Frank; Katagiri, Yuki; Barlis, Peter; Bourantas, Christos V.; Collet, Carlos; Coskun, U. Ugur; Daemen, Joost; Dijkstra, Jouke; Edelman, Elazer R.; Evans, Paul C.; Heiden, Kim Van der; Hose, Rod; Koo, Bon Kwon; Krams, Rob; Marsden, Alison L.; Migliavacca, Francesco; Onuma, Yoshinobu; Ooi, Andrew; Poon, Eric; Samady, Habib; Stone, Peter H.; Takahashi, Kuniaki; Tang, Dalin; Thondapu, Vikas; Tenekecioğlu, Erhan; Timmins, Lucas H.; Torii, Ryo; Wentzel, Jolanda J.; Serruys, Patrick W.

doi:10.1093/eurheartj/ehz551

Cited by 231 publications

(160 citation statements)

References 144 publications

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“…[35][36][37][38] The most extensively studied biomechanical forces are endothelial shear stress (ESS), plaque structural stress, and axial plaque stress. 7,35,39,40 In addition, a fluid-structure interaction model is being developed to define pulsatility as a determinant of the risk of plaque rupture (Supplementary material online, Appendix-Impact of local haemodynamic forces on plaque biology). Although larger clinical studies and more data are required, initial reports suggest that inclusion of biomechanical indices in prediction models may increase the accuracy of predicting risk of plaque erosion 41,42 -a pathophysiological mechanism recognized as underlying a substantial proportion of acute coronary events.…”

Section: Imaging Of the High-risk/culprit Coronary Plaquementioning

confidence: 99%

“…The principles of appropriate ESS computation and its potential clinical implications have been described in detail elsewhere. 7…”

Section: Imaging Of the High-risk/culprit Coronary Plaquementioning

confidence: 99%

“…Plaque rupture, plaque erosion, calcified nodule and functional coronary alterations represent pathophysiological mechanisms underlying acute coronary syndromes. Photography adapted from Partida et al6 and Gijsen et al7 (Creative Commons Licence CC-BY-NC).…”

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confidence: 99%

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Vulnerable plaques and patients: state-of-the-art

Tomaniak

Katagiri

Modolo

et al. 2020

European Heart Journal

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128

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Despite advanced understanding of the biology of atherosclerosis, coronary heart disease remains the leading cause of death worldwide. Progress has been challenging as half of the individuals who suffer sudden cardiac death do not experience premonitory symptoms. Furthermore, it is well-recognized that also a plaque that does not cause a haemodynamically significant stenosis can trigger a sudden cardiac event, yet the majority of ruptured or eroded plaques remain clinically silent. In the past 30 years since the term ‘vulnerable plaque’ was introduced, there have been major advances in the understanding of plaque pathogenesis and pathophysiology, shifting from pursuing features of ‘vulnerability’ of a specific lesion to the more comprehensive goal of identifying patient ‘cardiovascular vulnerability’. It has been also recognized that aside a thin-capped, lipid-rich plaque associated with plaque rupture, acute coronary syndromes (ACS) are also caused by plaque erosion underlying between 25% and 60% of ACS nowadays, by calcified nodule or by functional coronary alterations. While there have been advances in preventive strategies and in pharmacotherapy, with improved agents to reduce cholesterol, thrombosis, and inflammation, events continue to occur in patients receiving optimal medical treatment. Although at present the positive predictive value of imaging precursors of the culprit plaques remains too low for clinical relevance, improving coronary plaque imaging may be instrumental in guiding pharmacotherapy intensity and could facilitate optimal allocation of novel, more aggressive, and costly treatment strategies. Recent technical and diagnostic advances justify continuation of interdisciplinary research efforts to improve cardiovascular prognosis by both systemic and ‘local’ diagnostics and therapies. The present state-of-the-art document aims to present and critically appraise the latest evidence, developments, and future perspectives in detection, prevention, and treatment of ‘high-risk’ plaques occurring in ‘vulnerable’ patients.

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Section: Imaging Of the High-risk/culprit Coronary Plaquementioning

confidence: 99%

“…The principles of appropriate ESS computation and its potential clinical implications have been described in detail elsewhere. 7…”

Section: Imaging Of the High-risk/culprit Coronary Plaquementioning

confidence: 99%

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Vulnerable plaques and patients: state-of-the-art

Tomaniak

Katagiri

Modolo

et al. 2020

European Heart Journal

Self Cite

128

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“…The flow patterns and hemodynamic forces are not uniform in the vascular system. In straight parts of the arterial tree, blood flow is laminar and wall shear stress is high; in branches and curvatures, flow is disturbed with an irregular distribution of low wall stress [ 113 ]. While LSS upregulates the expression of EC genes and proteins with atheroprotective functions [ 114 ], disturbed flow with low shear stress determine endothelial dysfunction contributing to the development of vascular pathologies in concert with genetic, biochemical and lifestyle risk factors [ 115 ].…”

Section: Blood Vesselsmentioning

confidence: 99%

Harnessing Mechanosensation in Next Generation Cardiovascular Tissue Engineering

et al. 2020

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The ability of the cells to sense mechanical cues is an integral component of ”social” cell behavior inside tissues with a complex architecture. Through ”mechanosensation” cells are in fact able to decrypt motion, geometries and physical information of surrounding cells and extracellular matrices by activating intracellular pathways converging onto gene expression circuitries controlling cell and tissue homeostasis. Additionally, only recently cell mechanosensation has been integrated systematically as a crucial element in tissue pathophysiology. In the present review, we highlight some of the current efforts to assess the relevance of mechanical sensing into pathology modeling and manufacturing criteria for a next generation of cardiovascular tissue implants.

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“…This requires solving millions of nonlinear partial differential equations simultaneously and iteratively for thousands of small time steps in a cardiac cycle. These equations are not sufficient to solve for blood flow and there are multiple elements that are required in this process [62]: (i) image-based anatomy geometrical construction (ii) proper mesh generation (iii) realistic boundary conditions and (iv) blood properties and rheology (Table 1).…”

Section: Elements Of Computational Fluid Dynamics Modeling and Advancesmentioning

confidence: 99%

Physiology and coronary artery disease: emerging insights from computed tomography imaging based computational modeling

Eslami

Thondapu

Karády

et al. 2020

Int J Cardiovasc Imaging

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Improvements in spatial and temporal resolution now permit robust high quality characterization of presence, morphology and composition of coronary atherosclerosis in computed tomography (CT). These characteristics include high risk features such as large plaque volume, low CT attenuation, napkin-ring sign, spotty calcification and positive remodeling. Because of the high image quality, principles of patient-specific computational fluid dynamics modeling of blood flow through the coronary arteries can now be applied to CT and allow the calculation of local lesion-specific hemodynamics such as endothelial shear stress, fractional flow reserve and axial plaque stress. This review examines recent advances in coronary CT image-based computational modeling and discusses the opportunity to identify lesions at risk for rupture much earlier than today through the combination of anatomic and hemodynamic information.

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Expert recommendations on the assessment of wall shear stress in human coronary arteries: existing methodologies, technical considerations, and clinical applications

Abstract: Abstract

Cited by 231 publications

References 144 publications

Vulnerable plaques and patients: state-of-the-art

Vulnerable plaques and patients: state-of-the-art

Harnessing Mechanosensation in Next Generation Cardiovascular Tissue Engineering

Physiology and coronary artery disease: emerging insights from computed tomography imaging based computational modeling

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