# Lokale hemodynamische krachten en fenotype van coronaire plaques

*geplaatst 2019-07-01 · Algemeen · Heart (British Cardiac Society) · doi 10.1136/heartjnl-2018-314086 · https://hartvaat.nl/2019/07/01/lokale-hemodynamische-krachten-en-fenotype-van-coronaire-plaques/*

Studie naar de implicaties van lokale hemodynamische krachten (shear stress) op het fenotype van coronaire plaques.

## English: Implications of the local haemodynamic forces on the phenotype of coronary plaques.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: Heart (British Cardiac Society), https://doi.org/10.1136/heartjnl-2018-314086. Bijgewerkt 2026-07-03T13:27:13Z. 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.