期刊
JOURNAL OF THE AMERICAN HEART ASSOCIATION
卷 11, 期 3, 页码 -出版社
WILEY
DOI: 10.1161/JAHA.121.023502
关键词
fractional flow reserve; index of microcirculatory resistance; instantaneous wave-free ratio; wall shear stress
资金
- National Heart Foundation of Australia [102332]
This study aimed to evaluate the relationship between wall shear stress (WSS), functionally significant epicardial coronary stenoses, and microcirculatory dysfunction. The results showed that fractional flow reserve and instantaneous wave-free ratio independently predicted the total burden of low WSS and maximum lesion WSS in coronary arteries, while microcirculatory dysfunction was not associated with WSS.
Background The pathophysiological mechanism behind adverse outcomes associated with ischemia-inducing epicardial coronary stenoses and microcirculatory dysfunction remains unclear. Wall shear stress (WSS) plays an important role in atherosclerotic plaque progression and vulnerability. We aimed to evaluate the relationship between WSS, functionally significant epicardial coronary stenoses, and microcirculatory dysfunction. Methods and Results Patients undergoing invasive coronary physiology testing were included. Fractional flow reserve, instantaneous wave-free ratio, and the index of microcirculatory resistance were measured. Quantitative coronary angiography was used to obtain the lesion percentage diameter stenosis. Computational fluid dynamics analysis was performed to calculate WSS parameters. Multiple regression analysis was performed to calculate the standardized regression coefficient (beta) for the coronary physiology indices. A total of 107 vessels from 88 patients were included. Fractional flow reserve independently predicted the total area of low WSS (beta=-0.44; 95% CI, -0.62 to -0.25; P<0.001) and maximum lesion WSS (beta=-0.53; 95% CI, -0.70 to -0.36; P<0.001) after adjusting for percentage diameter stenosis and index of microcirculatory resistance. Similarly, instantaneous wave-free ratio also independently predicted the total area of low WSS (beta=-0.45; 95% CI, -0.62 to -0.28; P<0.001) and maximum lesion WSS (beta=-0.58; 95% CI, -0.73 to -0.43; P<0.001). The index of microcirculatory resistance did not predict either low or high WSS. Conclusions Fractional flow reserve and instantaneous wave-free ratio independently predicted the total burden of low WSS and maximum lesion WSS in coronary arteries. No relationship was found between microcirculatory dysfunction and WSS.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据