title: Association of remodeling with endothelial shear stress, plaque elasticity, and volume in coronary arteries: a pilot coronary computed tomography angiography study.
abstract: We sought to noninvasively assess the relationship between arterial remodeling, endothelial shear stress (ESS), and wall stiffness in coronary arteries. We studied 28 coronary arteries from 22 patients undergoing coronary computed tomography angiography (CCTA). The ESS was calculated in 2-mm long segments using computational fluid dynamics. Local remodeling, plaque dimensions, and local wall stiffness were assessed in each segment. The ESS was lower in the regions of excessive expansive remodeling versus compensatory expansive versus inadequate expansive versus constrictive remodeling. Areas of decreased wall stiffness more frequently exhibited excessive expansive remodeling. Plaque volume was higher in segments showing excessive expansive and inadequate remodeling than segments with constrictive remodeling. In conclusion, CCTA enables the noninvasive assessment of coronary hemodynamics and arterial/plaque morphology. Excessive expansive remodeling is associated with high-risk plaque features, such as low ESS, decreased plaque stiffness, and increased plaque volume. This methodology may be useful in the risk assessment of individual coronary lesions.
authors.affiliation: 11st Cardiology Department, AHEPA University General Hospital, Aristotle University Medical School, Thessaloniki, Greece.
authors.forename: Sotirios A
authors.initials: SA
authors.lastname: Katranas
authors.forename: Anastasios L
authors.initials: AL
authors.lastname: Kelekis
authors.forename: Antonios P
authors.initials: AP
authors.lastname: Antoniadis
authors.forename: Yiannis S
authors.initials: YS
authors.lastname: Chatzizisis
authors.forename: George D
authors.initials: GD
authors.lastname: Giannoglou
mesh_terms: D000368:Aged; D003198:Computer Simulation; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004548:Elasticity; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D010865:Pilot Projects; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted; D018570:Risk Assessment; D012307:Risk Factors; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D059289:Vascular Stiffness
keywords: arterial remodeling; coronary computed tomography angiography; coronary stiffness; endothelial shear stress; plaque volume