Identification of the haemodynamic environment permissive for plaque erosion

Abstract Endothelial erosion of atherosclerotic plaques is the underlying cause of approximately 30% of acute coronary syndromes (ACS). As the vascular endothelium is profoundly affected by the haemodynamic environment to which it is exposed, we employed computational fluid dynamic (CFD) analysis of...

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Autores principales:	Michael McElroy, Yongcheol Kim, Giampaolo Niccoli, Rocco Vergallo, Alexander Langford-Smith, Filippo Crea, Frank Gijsen, Thomas Johnson, Amir Keshmiri, Stephen J. White
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ef5b331bf76b40f18ac1af8a6885b00e
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spelling	oai:doaj.org-article:ef5b331bf76b40f18ac1af8a6885b00e2021-12-02T13:26:58ZIdentification of the haemodynamic environment permissive for plaque erosion10.1038/s41598-021-86501-x2045-2322https://doaj.org/article/ef5b331bf76b40f18ac1af8a6885b00e2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86501-xhttps://doaj.org/toc/2045-2322Abstract Endothelial erosion of atherosclerotic plaques is the underlying cause of approximately 30% of acute coronary syndromes (ACS). As the vascular endothelium is profoundly affected by the haemodynamic environment to which it is exposed, we employed computational fluid dynamic (CFD) analysis of the luminal geometry from 17 patients with optical coherence tomography (OCT)-defined plaque erosion, to determine the flow environment permissive for plaque erosion. Our results demonstrate that 15 of the 17 cases analysed occurred on stenotic plaques with median 31% diameter stenosis (interquartile range 28–52%), where all but one of the adherent thrombi located proximal to, or within the region of maximum stenosis. Consequently, all flow metrics related to elevated flow were significantly increased (time averaged wall shear stress, maximum wall shear stress, time averaged wall shear stress gradient) with a reduction in relative residence time, compared to a non-diseased reference segment. We also identified two cases that did not exhibit an elevation of flow, but occurred in a region exposed to elevated oscillatory flow. Our study demonstrates that the majority of OCT-defined erosions occur where the endothelium is exposed to elevated flow, a haemodynamic environment known to evoke a distinctive phenotypic response in endothelial cells.Michael McElroyYongcheol KimGiampaolo NiccoliRocco VergalloAlexander Langford-SmithFilippo CreaFrank GijsenThomas JohnsonAmir KeshmiriStephen J. WhiteNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Michael McElroy Yongcheol Kim Giampaolo Niccoli Rocco Vergallo Alexander Langford-Smith Filippo Crea Frank Gijsen Thomas Johnson Amir Keshmiri Stephen J. White Identification of the haemodynamic environment permissive for plaque erosion
description	Abstract Endothelial erosion of atherosclerotic plaques is the underlying cause of approximately 30% of acute coronary syndromes (ACS). As the vascular endothelium is profoundly affected by the haemodynamic environment to which it is exposed, we employed computational fluid dynamic (CFD) analysis of the luminal geometry from 17 patients with optical coherence tomography (OCT)-defined plaque erosion, to determine the flow environment permissive for plaque erosion. Our results demonstrate that 15 of the 17 cases analysed occurred on stenotic plaques with median 31% diameter stenosis (interquartile range 28–52%), where all but one of the adherent thrombi located proximal to, or within the region of maximum stenosis. Consequently, all flow metrics related to elevated flow were significantly increased (time averaged wall shear stress, maximum wall shear stress, time averaged wall shear stress gradient) with a reduction in relative residence time, compared to a non-diseased reference segment. We also identified two cases that did not exhibit an elevation of flow, but occurred in a region exposed to elevated oscillatory flow. Our study demonstrates that the majority of OCT-defined erosions occur where the endothelium is exposed to elevated flow, a haemodynamic environment known to evoke a distinctive phenotypic response in endothelial cells.
format	article
author	Michael McElroy Yongcheol Kim Giampaolo Niccoli Rocco Vergallo Alexander Langford-Smith Filippo Crea Frank Gijsen Thomas Johnson Amir Keshmiri Stephen J. White
author_facet	Michael McElroy Yongcheol Kim Giampaolo Niccoli Rocco Vergallo Alexander Langford-Smith Filippo Crea Frank Gijsen Thomas Johnson Amir Keshmiri Stephen J. White
author_sort	Michael McElroy
title	Identification of the haemodynamic environment permissive for plaque erosion
title_short	Identification of the haemodynamic environment permissive for plaque erosion
title_full	Identification of the haemodynamic environment permissive for plaque erosion
title_fullStr	Identification of the haemodynamic environment permissive for plaque erosion
title_full_unstemmed	Identification of the haemodynamic environment permissive for plaque erosion
title_sort	identification of the haemodynamic environment permissive for plaque erosion
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ef5b331bf76b40f18ac1af8a6885b00e
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Identification of the haemodynamic environment permissive for plaque erosion

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