title: Assessment of endothelial shear stress in patients with mild or intermediate coronary stenoses using coronary computed tomography angiography: comparison with invasive coronary angiography.
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 ESSCTAand ESSICAwere derived, respectively. Comparisons between ESSCTAand ESSICAwere performed on 163 segments of 57 vessels in the CTA and ICA models. ESSCTAand ESSICAwere 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 ESSCTAand the ESSICAwere 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.
authors: Department of Medical Imaging, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, 515041, Guangdong, People's Republic of China.
authors: Dexiao
authors: D
authors: Huang
authors: Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
authors: Takashi
authors: T
authors: Muramatsu
authors: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors: Yingguang
authors: Y
authors: Li
authors: Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Wenjie
authors: W
authors: Yang
authors: Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
authors: Yasuomi
authors: Y
authors: Nagahara
authors: Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
authors: Miao
authors: M
authors: Chu
authors: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors: Pieter
authors: P
authors: Kitslaar
authors: Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
authors: Masayoshi
authors: M
authors: Sarai
authors: Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
authors: Yukio
authors: Y
authors: Ozaki
authors: Cardiovascular Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, NE, USA.
authors: Yiannis S
authors: YS
authors: Chatzizisis
authors: Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Fuhua
authors: F
authors: Yan
authors: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors: Johan H C
authors: JHC
authors: Reiber
authors: Department of Medical Imaging, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, 515041, Guangdong, People's Republic of China. cjr.wurenhua@vip.163.com.
authors: Renhua
authors: R
authors: Wu
authors: Department of Cardiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. pujun310@hotmail.com.
authors: Jun
authors: J
authors: Pu
authors: Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
authors: Shengxian
authors: S
authors: Tu
mesh_terms: D000368:Aged; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D061330:Multidetector Computed Tomography; D066230:Patient-Specific Modeling; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011673:Pulsatile Flow; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013314:Stress, Mechanical
keywords: Computational fluid dynamics; Coronary computed tomography angiography; Endothelial shear stress; Invasive coronary angiography