Relationship of Coronary Angiography-Derived Radial Wall Strain With Functional Significance, Plaque Morphology, and Clinical Outcomes
Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Coronary angiography-derived radial wall strain (RWS) is a newly developed index that can be readily accessed and describes the biomechanical features of a lesion.
OBJECTIVES: The authors sought to investigate the association of RWS with fractional flow reserve (FFR) and high-risk plaque (HRP), and their relative prognostic implications.
METHODS: We included 484 vessels (351 patients) deferred after FFR measurement with available RWS data and coronary computed tomography angiography. On coronary computed tomography angiography, HRP was defined as a lesion with both minimum lumen area <4 mm2 and plaque burden ≥70%. The primary outcome was target vessel failure (TVF), a composite of target vessel revascularization, target vessel myocardial infarction, or cardiac death.
RESULTS: The mean FFR and RWSmax were 0.89 ± 0.07 and 11.2% ± 2.5%, respectively, whereas 27.7% of lesions had HRP, 15.1% had FFR ≤0.80. An increase in RWSmax was associated with a higher risk of FFR ≤0.80 and HRP, which was consistent after adjustment for clinical or angiographic characteristics (all P < 0.05). An increment of RWSmax was related to a higher risk of TVF (HR: 1.23 [95% CI: 1.03-1.47]; P = 0.022) with an optimal cutoff of 14.25%. RWSmax >14% was a predictor of TVF after adjustment for FFR or HRP components (all P < 0.05) and showed a direct prognostic effect on TVF, not mediated by FFR ≤0.80 or HRP in the mediation analysis. When high RWSmax was added to FFR ≤0.80 or HRP, there were increasing outcome trends (all P for trend <0.001).
CONCLUSIONS: RWS was associated with coronary physiology and plaque morphology but showed independent prognostic significance.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
JACC. Cardiovascular interventions - 17(2024), 1 vom: 08. Jan., Seite 46-56 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yang, Seokhun [VerfasserIn] |
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| Links: |
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| Themen: |
Angiography-derived radial wall strain |
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| Anmerkungen: |
Date Completed 12.01.2024 Date Revised 12.01.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1016/j.jcin.2023.10.003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366903403 |
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| 100 | 1 | |a Yang, Seokhun |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Relationship of Coronary Angiography-Derived Radial Wall Strain With Functional Significance, Plaque Morphology, and Clinical Outcomes |
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| 500 | |a Date Completed 12.01.2024 | ||
| 500 | |a Date Revised 12.01.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Coronary angiography-derived radial wall strain (RWS) is a newly developed index that can be readily accessed and describes the biomechanical features of a lesion | ||
| 520 | |a OBJECTIVES: The authors sought to investigate the association of RWS with fractional flow reserve (FFR) and high-risk plaque (HRP), and their relative prognostic implications | ||
| 520 | |a METHODS: We included 484 vessels (351 patients) deferred after FFR measurement with available RWS data and coronary computed tomography angiography. On coronary computed tomography angiography, HRP was defined as a lesion with both minimum lumen area <4 mm2 and plaque burden ≥70%. The primary outcome was target vessel failure (TVF), a composite of target vessel revascularization, target vessel myocardial infarction, or cardiac death | ||
| 520 | |a RESULTS: The mean FFR and RWSmax were 0.89 ± 0.07 and 11.2% ± 2.5%, respectively, whereas 27.7% of lesions had HRP, 15.1% had FFR ≤0.80. An increase in RWSmax was associated with a higher risk of FFR ≤0.80 and HRP, which was consistent after adjustment for clinical or angiographic characteristics (all P < 0.05). An increment of RWSmax was related to a higher risk of TVF (HR: 1.23 [95% CI: 1.03-1.47]; P = 0.022) with an optimal cutoff of 14.25%. RWSmax >14% was a predictor of TVF after adjustment for FFR or HRP components (all P < 0.05) and showed a direct prognostic effect on TVF, not mediated by FFR ≤0.80 or HRP in the mediation analysis. When high RWSmax was added to FFR ≤0.80 or HRP, there were increasing outcome trends (all P for trend <0.001) | ||
| 520 | |a CONCLUSIONS: RWS was associated with coronary physiology and plaque morphology but showed independent prognostic significance | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a angiography-derived radial wall strain | |
| 650 | 4 | |a coronary artery disease | |
| 650 | 4 | |a fractional flow reserve | |
| 650 | 4 | |a plaque characteristics | |
| 650 | 4 | |a quantitative flow ratio | |
| 700 | 1 | |a Wang, Zhiqing |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Sang-Hyeon |e verfasserin |4 aut | |
| 700 | 1 | |a Hong, Huihong |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Chunming |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Xun |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Lianglong |e verfasserin |4 aut | |
| 700 | 1 | |a Hwang, Doyeon |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Jinlong |e verfasserin |4 aut | |
| 700 | 1 | |a Hoshino, Masahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Yonetsu, Taishi |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Eun-Seok |e verfasserin |4 aut | |
| 700 | 1 | |a Doh, Joon-Hyung |e verfasserin |4 aut | |
| 700 | 1 | |a Nam, Chang-Wook |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jianan |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Shaoliang |e verfasserin |4 aut | |
| 700 | 1 | |a Tanaka, Nobuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuo, Hitoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kubo, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Hyuk-Jae |e verfasserin |4 aut | |
| 700 | 1 | |a Kakuta, Tsunekazu |e verfasserin |4 aut | |
| 700 | 1 | |a Koo, Bon-Kwon |e verfasserin |4 aut | |
| 700 | 1 | |a Tu, Shengxian |e verfasserin |4 aut | |
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