title: Comparison of angiographic and IVUS derived coronary geometric reconstructions for evaluation of the association of hemodynamics with coronary artery disease progression.
abstract: Wall shear stress (WSS) has been investigated as a prognostic marker for the prospective identification of rapidly progressing coronary artery disease (CAD) and atherosclerotic lesions likely to gain high-risk (vulnerable) characteristics. The goal of this study was to compare biplane angiographic vs. intravascular ultrasound (IVUS) derived reconstructed coronary geometries to evaluate agreement in geometry, computed WSS, and association of WSS and CAD progression. Baseline and 6-month follow-up angiographic and IVUS imaging data were collected in patients with non-obstructive CAD (n = 5). Three-dimensional (3D) reconstructions of the coronary arteries were generated with each technique, and patient-specific computational fluid dynamics models were constructed to compute baseline WSS values. Geometric comparisons were evaluated in arterial segments (n = 9), and hemodynamic data were evaluated in circumferential sections (n = 468). CAD progression was quantified from serial IVUS imaging data (n = 277), and included virtual-histology IVUS (VH-IVUS) derived changes in plaque composition. There was no significant difference in reconstructed coronary segment lengths and cross-sectional areas (CSA), however, IVUS derived geometries exhibited a significantly larger left main CSA than the angiographic reconstructions. Computed absolute time-averaged WSS (TAWSSABS) values were significantly greater in the IVUS derived geometries, however, evaluations of relative TAWSS (TAWSSREL) values revealed improved agreement and differences within defined zones of equivalence. Associations between VH-IVUS defined CAD progression and angiographic or IVUS derived WSS exhibited poor agreement when examining TAWSSABSdata, but improved when evaluating the association with TAWSSRELdata. We present data from a small cohort of patients highlighting strong agreement between angiographic and IVUS derived coronary geometries, however, limited agreement is observed between computed WSS values and associations of WSS with CAD progression.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA, 30322-4600, USA. lucas.timmins@bme.gatech.edu.|Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University School of Medicine, 313 Ferst Drive, Room 2127, Atlanta, GA, 30332, USA. lucas.timmins@bme.gatech.edu.|Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE Suite F606, Atlanta, GA, 30322, USA. lucas.timmins@bme.gatech.edu.
authors.forename: Lucas H
authors.initials: LH
authors.lastname: Timmins
authors.affiliation: Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University School of Medicine, 313 Ferst Drive, Room 2127, Atlanta, GA, 30332, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Suo
authors.affiliation: Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE Suite F606, Atlanta, GA, 30322, USA.
authors.forename: Parham
authors.initials: P
authors.lastname: Eshtehardi
authors.affiliation: Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University School of Medicine, 313 Ferst Drive, Room 2127, Atlanta, GA, 30332, USA.|Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE Suite F606, Atlanta, GA, 30322, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Molony
authors.affiliation: Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE Suite F606, Atlanta, GA, 30322, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: McDaniel
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA, 30322-4600, USA.|Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University School of Medicine, 313 Ferst Drive, Room 2127, Atlanta, GA, 30332, USA.
authors.forename: John N
authors.initials: JN
authors.lastname: Oshinski
authors.affiliation: Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University School of Medicine, 313 Ferst Drive, Room 2127, Atlanta, GA, 30332, USA.
authors.forename: Don P
authors.initials: DP
authors.lastname: Giddens
authors.affiliation: Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE Suite F606, Atlanta, GA, 30322, USA.
authors.forename: Habib
authors.initials: H
authors.lastname: Samady
mesh_terms: D000072226:Computed Tomography Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018450:Disease Progression; D006439:Hemodynamics; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D013314:Stress, Mechanical; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: Computational fluid dynamics; Coronary artery disease; Hemodynamic; Intravascular ultrasound; Quantitative coronary angiography; Wall shear stress