Optical Coherence Tomography-Derived Changes in Plaque Structural Stress Over the Cardiac Cycle: A New Method for Plaque Biomechanical Assessment
Introduction: Cyclic plaque structural stress has been hypothesized as a mechanism for plaque fatigue and eventually plaque rupture. A novel approach to derive cyclic plaque stress in vivo from optical coherence tomography (OCT) is hereby developed.Materials and Methods: All intermediate lesions fro...
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2021
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oai:doaj.org-article:0c959cf553e54b91948ca05dff09044d2021-11-04T07:18:49ZOptical Coherence Tomography-Derived Changes in Plaque Structural Stress Over the Cardiac Cycle: A New Method for Plaque Biomechanical Assessment2297-055X10.3389/fcvm.2021.715995https://doaj.org/article/0c959cf553e54b91948ca05dff09044d2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.715995/fullhttps://doaj.org/toc/2297-055XIntroduction: Cyclic plaque structural stress has been hypothesized as a mechanism for plaque fatigue and eventually plaque rupture. A novel approach to derive cyclic plaque stress in vivo from optical coherence tomography (OCT) is hereby developed.Materials and Methods: All intermediate lesions from a previous OCT study were enrolled. OCT cross-sections at representative positions within each lesion were selected for plaque stress analysis. Detailed plaque morphology, including plaque composition, lumen and internal elastic lamina contours, were automatically delineated. OCT-derived vessel and plaque morphology were included in a 2-dimensional finite element analysis, loaded with patient-specific intracoronary pressure tracing data, to calculate the changes in plaque structural stress (ΔPSS) on vessel wall over the cardiac cycle.Results: A total of 50 lesions from 41 vessels were analyzed. A significant ΔPSS gradient was observed across the plaque, being maximal at the proximal shoulder (45.7 [32.3, 78.6] kPa), intermediate at minimal lumen area (MLA) (39.0 [30.8, 69.1] kPa) and minimal at the distal shoulder (35.1 [28.2, 72.3] kPa; p = 0.046). The presence of lipidic plaques were observed in 82% of the diseased segments. Larger relative lumen deformation and ΔPSS were observed in diseased segments, compared with normal segments (percent diameter change: 8.2 ± 4.2% vs. 6.3 ± 2.3%, p = 0.04; ΔPSS: 59.3 ± 48.2 kPa vs. 27.5 ± 8.2 kPa, p < 0.001). ΔPSS was positively correlated with plaque burden (r = 0.37, p < 0.001) and negatively correlated with fibrous cap thickness (r = −0.25, p = 0.004).Conclusions: ΔPSS provides a feasible method for assessing plaque biomechanics in vivo from OCT images, consistent with previous biomechanical and clinical studies based on different methodologies. Larger ΔPSS at proximal shoulder and MLA indicates the critical sites for future biomechanical assessment.Jiayue HuangJiayue HuangFan YangJuan Luis Gutiérrez-ChicoTianxiao XuJigang WuLiang WangRui LvYan LaiXuebo LiuYoshinobu OnumaDalin TangDalin TangPatrick W. SerruysWilliam WijnsShengxian TuFrontiers Media S.A.articlebiomechanical assessmentfinite element analysisoptical coherence tomographyplaque structural stressplaque ruptureDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021) |
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biomechanical assessment finite element analysis optical coherence tomography plaque structural stress plaque rupture Diseases of the circulatory (Cardiovascular) system RC666-701 |
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biomechanical assessment finite element analysis optical coherence tomography plaque structural stress plaque rupture Diseases of the circulatory (Cardiovascular) system RC666-701 Jiayue Huang Jiayue Huang Fan Yang Juan Luis Gutiérrez-Chico Tianxiao Xu Jigang Wu Liang Wang Rui Lv Yan Lai Xuebo Liu Yoshinobu Onuma Dalin Tang Dalin Tang Patrick W. Serruys William Wijns Shengxian Tu Optical Coherence Tomography-Derived Changes in Plaque Structural Stress Over the Cardiac Cycle: A New Method for Plaque Biomechanical Assessment |
| description |
Introduction: Cyclic plaque structural stress has been hypothesized as a mechanism for plaque fatigue and eventually plaque rupture. A novel approach to derive cyclic plaque stress in vivo from optical coherence tomography (OCT) is hereby developed.Materials and Methods: All intermediate lesions from a previous OCT study were enrolled. OCT cross-sections at representative positions within each lesion were selected for plaque stress analysis. Detailed plaque morphology, including plaque composition, lumen and internal elastic lamina contours, were automatically delineated. OCT-derived vessel and plaque morphology were included in a 2-dimensional finite element analysis, loaded with patient-specific intracoronary pressure tracing data, to calculate the changes in plaque structural stress (ΔPSS) on vessel wall over the cardiac cycle.Results: A total of 50 lesions from 41 vessels were analyzed. A significant ΔPSS gradient was observed across the plaque, being maximal at the proximal shoulder (45.7 [32.3, 78.6] kPa), intermediate at minimal lumen area (MLA) (39.0 [30.8, 69.1] kPa) and minimal at the distal shoulder (35.1 [28.2, 72.3] kPa; p = 0.046). The presence of lipidic plaques were observed in 82% of the diseased segments. Larger relative lumen deformation and ΔPSS were observed in diseased segments, compared with normal segments (percent diameter change: 8.2 ± 4.2% vs. 6.3 ± 2.3%, p = 0.04; ΔPSS: 59.3 ± 48.2 kPa vs. 27.5 ± 8.2 kPa, p < 0.001). ΔPSS was positively correlated with plaque burden (r = 0.37, p < 0.001) and negatively correlated with fibrous cap thickness (r = −0.25, p = 0.004).Conclusions: ΔPSS provides a feasible method for assessing plaque biomechanics in vivo from OCT images, consistent with previous biomechanical and clinical studies based on different methodologies. Larger ΔPSS at proximal shoulder and MLA indicates the critical sites for future biomechanical assessment. |
| format |
article |
| author |
Jiayue Huang Jiayue Huang Fan Yang Juan Luis Gutiérrez-Chico Tianxiao Xu Jigang Wu Liang Wang Rui Lv Yan Lai Xuebo Liu Yoshinobu Onuma Dalin Tang Dalin Tang Patrick W. Serruys William Wijns Shengxian Tu |
| author_facet |
Jiayue Huang Jiayue Huang Fan Yang Juan Luis Gutiérrez-Chico Tianxiao Xu Jigang Wu Liang Wang Rui Lv Yan Lai Xuebo Liu Yoshinobu Onuma Dalin Tang Dalin Tang Patrick W. Serruys William Wijns Shengxian Tu |
| author_sort |
Jiayue Huang |
| title |
Optical Coherence Tomography-Derived Changes in Plaque Structural Stress Over the Cardiac Cycle: A New Method for Plaque Biomechanical Assessment |
| title_short |
Optical Coherence Tomography-Derived Changes in Plaque Structural Stress Over the Cardiac Cycle: A New Method for Plaque Biomechanical Assessment |
| title_full |
Optical Coherence Tomography-Derived Changes in Plaque Structural Stress Over the Cardiac Cycle: A New Method for Plaque Biomechanical Assessment |
| title_fullStr |
Optical Coherence Tomography-Derived Changes in Plaque Structural Stress Over the Cardiac Cycle: A New Method for Plaque Biomechanical Assessment |
| title_full_unstemmed |
Optical Coherence Tomography-Derived Changes in Plaque Structural Stress Over the Cardiac Cycle: A New Method for Plaque Biomechanical Assessment |
| title_sort |
optical coherence tomography-derived changes in plaque structural stress over the cardiac cycle: a new method for plaque biomechanical assessment |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/0c959cf553e54b91948ca05dff09044d |
| work_keys_str_mv |
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