High wall shear stress is related to atherosclerotic plaque rupture in the aortic arch of patients with cardiovascular disease: A study with computational fluid dynamics model and non-obstructive general angioscopy

Keisuke Kojima, Takafumi Hiro, Yutaka Koyama, Akihito Ohgaku, Hidesato Fujito, Yasunari Ebuchi, Riku Arai, Masaki Monden, Suguru Migita, Tomoyuki Morikawa, Takehiro Tamaki, Nobuhiro Murata, Naotaka Akutsu, Toshihiko Nishida, Daisuke Kitano, Mitsumasa Sudo, Daisuke Fukamachi, Shunichi Yoda, Tadateru Takayama, Atsushi HirayamaYasuo Okumura

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Aims: Wall shear stress (WSS) has been considered a major determinant of aortic atherosclerosis. Recently, non-obstructive general angioscopy (NOGA) was developed to visualize various atherosclerotic pathologies, including in vivo ruptured plaque (RP) in the aorta. However, the relationship between aortic RP and WSS distribution within the aortic wall is unclear. This study aimed to investigate the relationship between aortic NOGA-derived RP and the stereographic distribution of WSS by computational fluid dynamics (CFD) modeling using three-dimensional computed tomography (3D-CT) angiography. Methods: We investigated 45 consecutive patients who underwent 3D-CT before coronary angiography and NOGA during coronary angiography. WSS in the aortic arch was measured by CFD analysis based on the finite element method using uniform inlet and outlet flow conditions. Aortic RP was detected by NOGA. Results: Patients with a distinct RP showed a significantly higher maximum WSS value in the aortic arch than those without aortic RP (56.2±30.6 Pa vs 36.2±19.8 Pa, p=0.017), no significant difference was noted in the mean WSS between those with and without aortic RP. In a multivariate logistic regression analysis, the presence of a maximum WSS value more than a specific value was a significant predictor of aortic RP (odds ratio 7.21, 95% confidence interval 1.78-37.1, p =0.005). Conclusions: Aortic RP detected by NOGA was strongly associated with a higher maximum WSS in the aortic arch derived by CFD using 3D-CT. The maximum WSS value may have an important role in the underlying mechanism of not only aortic atherosclerosis, but also aortic RP.

Original languageEnglish
Pages (from-to)742-753
Number of pages12
JournalJournal of Atherosclerosis and Thrombosis
Volume28
Issue number7
DOIs
Publication statusPublished - 2021

Keywords

  • Aortic arch
  • Atherosclerotic ruptured plaque
  • Computational fluid dynamics
  • Non-obstructive general angioscopy
  • Wall shear stress

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