title: Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs.
abstract: BACKGROUND
  Although disturbed flow is thought to play a central role in the development of advanced coronary atherosclerotic plaques, no causal relationship has been established. We evaluated whether inducing disturbed flow would cause the development of advanced coronary plaques, including thin cap fibroatheroma.
  
  
  RESULTS
  D374Y-PCSK9 hypercholesterolemic minipigs (n=5) were instrumented with an intracoronary shear-modifying stent (SMS). Frequency-domain optical coherence tomography was obtained at baseline, immediately poststent, 19 weeks, and 34 weeks, and used to compute shear stress metrics of disturbed flow. At 34 weeks, plaque type was assessed within serially collected histological sections and coregistered to the distribution of each shear metric. The SMS caused a flow-limiting stenosis, and blood flow exiting the SMS caused regions of increased shear stress on the outer curvature and large regions of low and multidirectional shear stress on the inner curvature of the vessel. As a result, plaque burden was ≈3-fold higher downstream of the SMS than both upstream of the SMS and in the control artery (P<0.001). Advanced plaques were also primarily observed downstream of the SMS, in locations initially exposed to both low (P<0.002) and multidirectional (P<0.002) shear stress. Thin cap fibroatheroma regions demonstrated significantly lower shear stress that persisted over the duration of the study in comparison with other plaque types (P<0.005).
  
  
  CONCLUSIONS
  These data support a causal role for lowered and multidirectional shear stress in the initiation of advanced coronary atherosclerotic plaques. Persistently lowered shear stress appears to be the principal flow disturbance needed for the formation of thin cap fibroatheroma.
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Pedrigi
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Christian Bo
authors.initials: CB
authors.lastname: Poulsen
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Vikram V
authors.initials: VV
authors.lastname: Mehta
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Niels
authors.initials: N
authors.lastname: Ramsing Holm
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Nilesh
authors.initials: N
authors.lastname: Pareek
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Anouk L
authors.initials: AL
authors.lastname: Post
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Ismail Dogu
authors.initials: ID
authors.lastname: Kilic
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Winston A S
authors.initials: WA
authors.lastname: Banya
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Gianni
authors.initials: G
authors.lastname: Dall'Ara
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Martin M
authors.initials: MM
authors.lastname: Bjørklund
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Niels P
authors.initials: NP
authors.lastname: Andersen
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Anna K
authors.initials: AK
authors.lastname: Grøndal
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Enrico
authors.initials: E
authors.lastname: Petretto
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Nicolas
authors.initials: N
authors.lastname: Foin
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Justin E
authors.initials: JE
authors.lastname: Davies
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Jacob
authors.initials: J
authors.lastname: Fog Bentzon
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Hans
authors.initials: H
authors.lastname: Erik Bøtker
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Erling
authors.initials: E
authors.lastname: Falk
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.).
authors.forename: Rob
authors.initials: R
authors.lastname: Krams
authors.affiliation: From Department of Bioengineering, Imperial College London, United Kingdom (R.M.P., V.V.M., A.L.P., R.K.); Institute of Clinical Medicine, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., E.F.); Department of Cardiology, Aarhus University Hospital, Denmark (C.B.P., N.R.H., M.M.B., N.P.A., A.K.G., J.F.B., H.E.B., E.F.); NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (I.D.K., W.A.S.B., G.D.'A., A.M., C.D.M., R.d.S.); Graduate Medical School, Duke-National University of Singapore, Singapore (E.P.); National Heart Centre, NHRIS, Singapore (N.F.); National Heart and Lung Institute, Imperial College London, United Kingdom (C.D.M., R.d.S.); and Institute of Cardiovascular Medicine and Science, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom (C.D.M., R.d.S.). r.desilva@imperial.ac.uk.
authors.forename: Ranil
authors.initials: R
authors.lastname: de Silva
mesh_terms: D000818:Animals; D030801:Animals, Genetically Modified; D050197:Atherosclerosis / Q000209:etiology* / Q000503:physiopathology*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000503:physiopathology*; D004195:Disease Models, Animal; D006439:Hemodynamics / Q000502:physiology; D006937:Hypercholesterolemia / Q000150:complications* / Q000235:genetics / Q000503:physiopathology; D058226:Plaque, Atherosclerotic / Q000209:etiology* / Q000503:physiopathology*; D043484:Proprotein Convertases / Q000235:genetics; D012039:Regional Blood Flow / Q000502:physiology*; D033081:Shear Strength / Q000502:physiology; D015607:Stents; D013314:Stress, Mechanical; D013552:Swine; D013556:Swine, Miniature; D013997:Time Factors; D041623:Tomography, Optical Coherence
chemical_list: D043484:Proprotein Convertases
keywords: atherosclerosis; biophysics; endothelium; hemodynamics; plaque, atherosclerotic; shear stress; tomography, optical coherence