{"id":"f25249f80098","type":"article","url":"https://hartvaat.nl/2019/07/01/lokale-hemodynamische-krachten-en-fenotype-van-coronaire-plaques/","title":"Lokale hemodynamische krachten en fenotype van coronaire plaques","title_en":"Implications of the local haemodynamic forces on the phenotype of coronary plaques.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2018-314086","source_url":"https://doi.org/10.1136/heartjnl-2018-314086","authors":["Christos V Bourantas","Thomas Zanchin","Antonis Sakellarios","Alexios Karagiannis","Anantharaman Ramasamy","Kyohei Yamaji","Masanori Taniwaki","Dik Heg","Aris Moschovitis","Dimitrios Fotiadis","Lampros Mihalis","Andreas Baumbach","Ryo Torii","Patrick Serruys","Hector M Garcia-Garcia","Stephan Windecker","Lorenz Räber"],"significance":5,"published":"2019-07-01","source_date":"2019-07-01","image":"","kennis":[],"congress":"","summary_en":"This study examined how endothelial shear stress influences dynamic changes in coronary plaque phenotype, linking local hemodynamic forces to the progression or stabilization of vulnerable atherosclerotic lesions.","created":"2026-07-03T10:28:01Z","updated":"2026-07-03T13:27:13Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de implicaties van lokale hemodynamische krachten (shear stress) op het fenotype van coronaire plaques.","abstract_original":"AIM: To examine the effect of endothelial shear stress (ESS) on the dynamic changes in plaque phenotype. METHODS: Patients with myocardial infarction that had intravascular ultrasound-virtual histology (IVUS-VH) and optical coherence tomography (OCT) at baseline and 13-month follow-up were studied. The IVUS-VH data were used to reconstruct the nonculprit vessels, and in the obtained models the ESS was estimated in 3 mm segments. Plaque morphology was derived in each segment from IVUS-VH and OCT. Disease progression was defined as the presence of ≥2 out of the following criteria: reduction in lumen area, increase in plaque burden and change of plaque morphology to a more vulnerable phenotype. Linear mixed effects models were used to assess the effect of ESS in different phenotypes. RESULTS: Sixty-eight vessels were included in the analysis. Low ESS was associated with plaque progression in all phenotypes. The effect of ESS on plaque burden (p for interaction=0.467) and phenotype (p for interaction=0.188) was similar in all plaque types, whereas the effect of ESS on the changes in lumen dimensions was more prominent in disease-free (β=0.70, p<0.001) than fibrotic/fibrocalcific (β=0.28, p<0.001) or lipid-rich plaques (β=0.15, p=0.015). Standalone IVUS-VH misclassified plaque morphology in one-third of the cases leading to erroneous estimations about the effect of ESS on plaque evolution in different phenotypes. CONCLUSIONS: The effect of ESS on plaque progression is similar in all phenotypes and cannot be accurately assessed by standalone IVUS-VH which often misclassifies plaque morphology. Therefore, multimodality imaging should be considered to examine the implications of ESS on plaque evolution. CLINICAL TRIAL REGISTRATION: NCT00962416; Post-results."}