Güneş Hüseyinova1, Emre Aslanger2, Ozan Çakır3, Adem Atıcı4, Cafer Panç5, Ahmet Demirkıran6, Semih Sürmen7, Remzi Sarıkaya8, Onur Erdoğan9, Ebru Gölcük10, Sabahattin Umman11, Murat Sezer12. 1. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: dunkan8@gmail.com. 2. Koç University School of Medicine, Department of Cardiology, Turkey. Electronic address: easlanger@kuh.ku.edu.tr. 3. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: mozancakir@yahoo.com. 4. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: adematici10@gmail.com. 5. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: caferpanc@gmail.com. 6. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: ademirkiran@hotmail.com. 7. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: surmen@gmail.com. 8. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: remzisarikaya@hotmail.com. 9. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: onurerdogan86@gmail.com. 10. Koç University School of Medicine, Department of Cardiology, Turkey. Electronic address: sgolcuk@kuh.ku.edu.tr. 11. Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Turkey. Electronic address: summan@istanbul.edu.tr. 12. Koç University School of Medicine, Department of Cardiology, Turkey. Electronic address: muratsezer@ku.edu.tr.
Abstract
OBJECTIVE: Histologic plaque characteristics may influence the hemodynamic effect generated by physiologically significant unstable coronary lesions where plaque content and surface related factors are expected to contribute to the maximum translesional pressure drop. In this study, we aimed to identify local lesion specific virtual histological characteristics that may potentially affect hemodynamic outcome measures. METHODS: Forty-eight consecutive patients with non-ST-elevation acute coronary syndrome (NSTEACS) having paired hemodynamic and morphological data were enrolled. A dual sensor guide-wire was used for the assessment of fractional flow reserve (FFR) and stenosis resistance (HSR) in the culprit vessel. Virtual histology intravascular ultrasound imaging was performed after obtaining hemodynamic data. RESULTS: In a hemodynamically significant lesion subset (FFR<0.75 [n=34]), after controlling for lesion length, MLA and coronary artery compliance, FFR correlated with necrotic core (NC) area (r=-0.423, p=0.028) at MLA and NC volume (r=-0.497, p=0.008) and dense calcium (DC) volume (r=-0.332, p=0.03) across the entire lesion segment. Likewise, NC (r=-0.544, p=0.005) and DC (r=0.376, p=0.03) areas at MLA and NC (r=0.545, p=0.005) and DC (r=0.576, p=0.003) volumes across the entire lesion segment were associated with HSR in the hemodynamically significant lesion group (HSR>0.80 [n=33]). However, no correlation has been observed between intracoronary hemodynamic end-points and plaque components in hemodynamically insignificant lesions. CONCLUSIONS: This study demonstrated that for a given coronary stenosis geometry and arterial compliance, plaque composition may influence hemodynamic outcome measures in functionally significant stenoses in patients with NSTEACS.
OBJECTIVE: Histologic plaque characteristics may influence the hemodynamic effect generated by physiologically significant unstable coronary lesions where plaque content and surface related factors are expected to contribute to the maximum translesional pressure drop. In this study, we aimed to identify local lesion specific virtual histological characteristics that may potentially affect hemodynamic outcome measures. METHODS: Forty-eight consecutive patients with non-ST-elevation acute coronary syndrome (NSTEACS) having paired hemodynamic and morphological data were enrolled. A dual sensor guide-wire was used for the assessment of fractional flow reserve (FFR) and stenosis resistance (HSR) in the culprit vessel. Virtual histology intravascular ultrasound imaging was performed after obtaining hemodynamic data. RESULTS: In a hemodynamically significant lesion subset (FFR<0.75 [n=34]), after controlling for lesion length, MLA and coronary artery compliance, FFR correlated with necrotic core (NC) area (r=-0.423, p=0.028) at MLA and NC volume (r=-0.497, p=0.008) and dense calcium (DC) volume (r=-0.332, p=0.03) across the entire lesion segment. Likewise, NC (r=-0.544, p=0.005) and DC (r=0.376, p=0.03) areas at MLA and NC (r=0.545, p=0.005) and DC (r=0.576, p=0.003) volumes across the entire lesion segment were associated with HSR in the hemodynamically significant lesion group (HSR>0.80 [n=33]). However, no correlation has been observed between intracoronary hemodynamic end-points and plaque components in hemodynamically insignificant lesions. CONCLUSIONS: This study demonstrated that for a given coronary stenosis geometry and arterial compliance, plaque composition may influence hemodynamic outcome measures in functionally significant stenoses in patients with NSTEACS.
Authors: Costantino Caroselli; Rosario De Rosa; Pietro Tanzi; Alberto Rigatelli; Guglielmo Bruno Journal: Int J Immunopathol Pharmacol Date: 2015-12-18 Impact factor: 3.219