Mingzi Zhang, Ramtin Gharleghi, Chi Shen, Susann Beier
{"title":"重新认识冠状动脉曲率和血流动力学对斑块形成和发展过程的影响。","authors":"Mingzi Zhang, Ramtin Gharleghi, Chi Shen, Susann Beier","doi":"10.1098/rsos.241267","DOIUrl":null,"url":null,"abstract":"<p><p>The strong link between atherosclerosis and luminal biomechanical stresses is well established. Yet, this understanding has not translated into preventative coronary diagnostic imaging, particularly due to the under-explored role of coronary anatomy and haemodynamics in plaque onset, which we aim to address with this work. The left coronary trees of 20 non-stenosed (%diameter stenosis [%DS] = 0), 12 moderately (0 < %DS < 70) and 7 severely (%DS ≥ 70) stenosed cases were dissected into bifurcating and non-bifurcating segments for whole-tree and segment-specific comparisons, correlating nine three-dimensional coronary anatomical features, topological shear variation index (TSVI) and luminal areas subject to low time-average endothelial shear stress (%LowTAESS), high oscillatory shear index (%HighOSI) and high relative residence time (%HighRRT). We found that TSVI is the only metric consistently differing between non-stenosed and stenosed cases across the whole tree, bifurcating and non-bifurcating segments (<i>p </i>< 0.002, AUC = 0.876), whereas average curvature and %HighOSI differed only for the whole trees (<i>p </i>< 0.024) and non-bifurcating segments (<i>p </i>< 0.027), with AUC > 0.711. Coronary trees with moderate or severe stenoses differed only in %LowTAESS (<i>p </i>= 0.009) and %HighRRT (<i>p </i>= 0.012). This suggests TSVI, curvature and %HighOSI are potential factors driving plaque onset, with greater predictive performance than the previously recognized %LowTAESS and %HighRRT, which appears to play a role in plaque progression.</p>","PeriodicalId":21525,"journal":{"name":"Royal Society Open Science","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416812/pdf/","citationCount":"0","resultStr":"{\"title\":\"A new understanding of coronary curvature and haemodynamic impact on the course of plaque onset and progression.\",\"authors\":\"Mingzi Zhang, Ramtin Gharleghi, Chi Shen, Susann Beier\",\"doi\":\"10.1098/rsos.241267\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The strong link between atherosclerosis and luminal biomechanical stresses is well established. Yet, this understanding has not translated into preventative coronary diagnostic imaging, particularly due to the under-explored role of coronary anatomy and haemodynamics in plaque onset, which we aim to address with this work. The left coronary trees of 20 non-stenosed (%diameter stenosis [%DS] = 0), 12 moderately (0 < %DS < 70) and 7 severely (%DS ≥ 70) stenosed cases were dissected into bifurcating and non-bifurcating segments for whole-tree and segment-specific comparisons, correlating nine three-dimensional coronary anatomical features, topological shear variation index (TSVI) and luminal areas subject to low time-average endothelial shear stress (%LowTAESS), high oscillatory shear index (%HighOSI) and high relative residence time (%HighRRT). We found that TSVI is the only metric consistently differing between non-stenosed and stenosed cases across the whole tree, bifurcating and non-bifurcating segments (<i>p </i>< 0.002, AUC = 0.876), whereas average curvature and %HighOSI differed only for the whole trees (<i>p </i>< 0.024) and non-bifurcating segments (<i>p </i>< 0.027), with AUC > 0.711. Coronary trees with moderate or severe stenoses differed only in %LowTAESS (<i>p </i>= 0.009) and %HighRRT (<i>p </i>= 0.012). This suggests TSVI, curvature and %HighOSI are potential factors driving plaque onset, with greater predictive performance than the previously recognized %LowTAESS and %HighRRT, which appears to play a role in plaque progression.</p>\",\"PeriodicalId\":21525,\"journal\":{\"name\":\"Royal Society Open Science\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416812/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Royal Society Open Science\",\"FirstCategoryId\":\"103\",\"ListUrlMain\":\"https://doi.org/10.1098/rsos.241267\",\"RegionNum\":3,\"RegionCategory\":\"综合性期刊\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"MULTIDISCIPLINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Royal Society Open Science","FirstCategoryId":"103","ListUrlMain":"https://doi.org/10.1098/rsos.241267","RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MULTIDISCIPLINARY SCIENCES","Score":null,"Total":0}
A new understanding of coronary curvature and haemodynamic impact on the course of plaque onset and progression.
The strong link between atherosclerosis and luminal biomechanical stresses is well established. Yet, this understanding has not translated into preventative coronary diagnostic imaging, particularly due to the under-explored role of coronary anatomy and haemodynamics in plaque onset, which we aim to address with this work. The left coronary trees of 20 non-stenosed (%diameter stenosis [%DS] = 0), 12 moderately (0 < %DS < 70) and 7 severely (%DS ≥ 70) stenosed cases were dissected into bifurcating and non-bifurcating segments for whole-tree and segment-specific comparisons, correlating nine three-dimensional coronary anatomical features, topological shear variation index (TSVI) and luminal areas subject to low time-average endothelial shear stress (%LowTAESS), high oscillatory shear index (%HighOSI) and high relative residence time (%HighRRT). We found that TSVI is the only metric consistently differing between non-stenosed and stenosed cases across the whole tree, bifurcating and non-bifurcating segments (p < 0.002, AUC = 0.876), whereas average curvature and %HighOSI differed only for the whole trees (p < 0.024) and non-bifurcating segments (p < 0.027), with AUC > 0.711. Coronary trees with moderate or severe stenoses differed only in %LowTAESS (p = 0.009) and %HighRRT (p = 0.012). This suggests TSVI, curvature and %HighOSI are potential factors driving plaque onset, with greater predictive performance than the previously recognized %LowTAESS and %HighRRT, which appears to play a role in plaque progression.
期刊介绍:
Royal Society Open Science is a new open journal publishing high-quality original research across the entire range of science on the basis of objective peer-review.
The journal covers the entire range of science and mathematics and will allow the Society to publish all the high-quality work it receives without the usual restrictions on scope, length or impact.