Coronary Artery Axial Plaque Stress and its Relationship With Lesion Geometry: Application of Computational Fluid Dynamics to Coronary CT Angiography

摘要: Abstract Objectives The purpose of this study was to characterize the hemodynamic force acting on plaque and investigate its relationship with lesion geometry. Background Coronary rupture occurs when stress exceeds strength. Methods Computational fluid dynamics applied 114 lesions (81 patients) from coronary computed tomography angiography. axial (APS) by extracting component stenotic lesions, asymmetry assessed luminal radius change over length (radius gradient [RG]). Lesions were divided into upstream-dominant (upstream RG > downstream RG) downstream-dominant RG  Results Thirty-three (28.9%) showed net retrograde force. Upstream APS linearly increased as severity increased, whereas exhibited a concave function for severity. There negative correlation (r = −0.274, p = 0.003) between length. pressure gradient, tomography–derived fractional flow reserve (FFRCT), wall shear consistently higher in upstream segments, regardless asymmetry. However, segment (11,371.96 ± 5,575.14 dyne/cm2 vs. 6,878.14 4,319.51 dyne/cm2, p  Conclusions uniquely characterizes has strong Clinical application these geometric indices may be helpful assess future risk determine treatment strategy patients artery disease. (Evaluation FFR, WSS, TPF Using CCTA; NCT01857687)