Coronary Artery Disease
Conditions
Keywords
Optical coherence tomography, Axial Plaque Stress, Wall Shear Stress, Vulnerability
Brief summary
In this study, the investigators sought to evaluate the feasibility of estimating external hemodynamic stress acting plaque with the use of invasively measured hemodynamic data from pressure wire pullback tracing. In addition, the investigators will also evaluate detailed plaque geometry and vulnerability using optical coherence tomography along with the hemodynamic stress.
Detailed description
It has been well known that mechanism of acute coronary syndrome is plaque rupture and occlusion of coronary artery by this plaque rupture. Although current risk assessment for plaque rupture have mainly focused on evaluation of plaque vulnerability. However, according to the general mechanism of material failure, plaque rupture occurs whenever the external hemodynamic stress exceeds the durability of the plaque. Recently, we evaluated the axial plaque stress, which is axial component of total traction acting on the plaque, and showed that the axial plaque stress possess significantly higher magnitude than previously known wall shear stress. However, the axial plaque stress in our previous research was measured with computational flow dynamics analysis using coronary artery model from coronary CT angiography. In this study, we sought to evaluate the feasibility of estimating external hemodynamic stress acting plaque with the use of invasively measured hemodynamic data from pressure wire pullback tracing. In addition, we will also evaluate detailed plaque geometry and vulnerability using optical coherence tomography along with the hemodynamic stress.
Interventions
PROCEDUREDevice
Optical coherence tomography to evaluate plaque morphology and vulnerable features (ex\> cap thickness, spotty calcification)
Sponsors
Seoul National University Hospital
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 1\. Patients with angina pectoris who are scheduled to do invasive coronary angiography. * 2\. Patients who have moderate (40-70%) stenosis at proximal or mid-portion of major coronary arteries. * 3\. Pressure wire pullback tracing and Optical Coherence Tomography ware successfully performed
Exclusion criteria
* 1\. Stenosis at distal coronary or small vessel. * 2\. Patients who don't have moderate (40-70%) stenosis at proximal or mid-portion of major coronary arteries. Confirmed by invasive coronary angiography. * 3\. Inadequate quality of Optical Coherence Tomography * 4\. No data of Fractional Flow Reserve or Pressure wire pullback tracing or inadequate data of Fractional Flow Reserve or Pressure wire pullback tracing
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Axial plaque stress (Axial component of total traction acting on the plaque) | up to 1 week | — |
| Cap thickness (measured from optical coherent tomography) | up to 1 week | Cap thickness measured from optical coherent tomography |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cardiac death and all-cause mortality | 1 year | Between High-hemodynamic force plaque and Low-hemodynamic force plaque |
| Proportion of thin cap fibrous atheroma | up to 1 week | Plaques with cap thickness \< 60um |
| Target vessel restenosis | 1 year | Between High-hemodynamic force plaque and Low-hemodynamic force plaque |
| Non-fatal target vessel myocardial infarction | 1 year | Between High-hemodynamic force plaque and Low-hemodynamic force plaque |
| Wall shear stress (Friction vector on the surface of the plaque) | up to 1 week | Friction vector on the surface of the plaque |
Countries
South Korea
Contacts
Primary ContactBon-Kwon Koo, MD, PhD
Backup ContactJoo Myung Lee, MD, MPH
Outcome results
None listed