Coronary artery plaque formation at coronary CT angiography: morphological analysis and relationship to hemodynamics
We aimed to demonstrate that coronary CT angiography (cCTA) can be used to non-invasively study the effect of hemodynamic factors in the pathophysiology of plaque formation. cCTA data of 73 patients were analyzed. All detected plaques were classified according to location (bifurcation, non-branching...
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| Veröffentlicht in: | European radiology 2009-04, Vol.19 (4), p.837-844 |
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| creator | Enrico, Benedetta Suranyi, Pal Thilo, Christian Bonomo, Lorenzo Costello, Philip Schoepf, U. Joseph |
| description | We aimed to demonstrate that coronary CT angiography (cCTA) can be used to non-invasively study the effect of hemodynamic factors in the pathophysiology of plaque formation. cCTA data of 73 patients were analyzed. All detected plaques were classified according to location (bifurcation, non-branching segment), configuration (eccentric, concentric), orientation (myocardial, lateral, epicardial side of the vessel wall), and composition (calcified, mixed, non-calcified). Bifurcation lesions were further characterized using the Medina classification. Of 382 plaques, 8.1% were in the LM, 46.3% in the LAD, 18.3% in the LCx, and 25.9% in the RCA. Also, 25.1% were completely calcified, 72.3% were mixed, and 2.6% were purely non-calcified. Of the plaques, 51.3% were bifurcation lesions. The most frequent (40%) Medina pattern was 1.1.0 (lesion starts before, extends beyond bifurcation, sparing the side branch). Eighty percent of plaques were eccentric. A significant (p |
| doi_str_mv | 10.1007/s00330-008-1223-3 |
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Joseph</creator><creatorcontrib>Enrico, Benedetta ; Suranyi, Pal ; Thilo, Christian ; Bonomo, Lorenzo ; Costello, Philip ; Schoepf, U. Joseph</creatorcontrib><description>We aimed to demonstrate that coronary CT angiography (cCTA) can be used to non-invasively study the effect of hemodynamic factors in the pathophysiology of plaque formation. cCTA data of 73 patients were analyzed. All detected plaques were classified according to location (bifurcation, non-branching segment), configuration (eccentric, concentric), orientation (myocardial, lateral, epicardial side of the vessel wall), and composition (calcified, mixed, non-calcified). Bifurcation lesions were further characterized using the Medina classification. Of 382 plaques, 8.1% were in the LM, 46.3% in the LAD, 18.3% in the LCx, and 25.9% in the RCA. Also, 25.1% were completely calcified, 72.3% were mixed, and 2.6% were purely non-calcified. Of the plaques, 51.3% were bifurcation lesions. The most frequent (40%) Medina pattern was 1.1.0 (lesion starts before, extends beyond bifurcation, sparing the side branch). Eighty percent of plaques were eccentric. A significant (p < 0.01) majority (55%) were on the myocardial side, while 17.3% were lateral, and 27.7% epicardial. Of all non-calcified and mixed plaques, 45.1% (p < 0.01) were myocardial, whereas only 14.3% were lateral, 20.6% epicardial, and 19.9% concentric. We conclude that cCTA can non-invasively study the effect of vascular hemodynamics, such as turbulent flow (bifurcations) and low shear stress (myocardial vessel wall), on the distribution and composition of atherosclerotic plaque deposition.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-008-1223-3</identifier><identifier>PMID: 19011863</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Aged ; Atherosclerosis ; Atherosclerosis - diagnosis ; Atherosclerosis - pathology ; Blood Vessels - pathology ; Calcification ; Cardiac ; Cardiovascular disease ; Catheters ; Coronary Angiography - instrumentation ; Coronary Angiography - methods ; Coronary vessels ; Coronary Vessels - pathology ; Diagnostic Radiology ; Endothelium, Vascular - cytology ; Endothelium, Vascular - pathology ; Female ; Hemodynamics ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Male ; Medical imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Morphology ; Neuroradiology ; Patients ; Radiology ; Retrospective Studies ; Risk ; Shear stress ; Tomography, X-Ray Computed - instrumentation ; Tomography, X-Ray Computed - methods ; Ultrasound ; Vein & artery diseases</subject><ispartof>European radiology, 2009-04, Vol.19 (4), p.837-844</ispartof><rights>European Society of Radiology 2008</rights><rights>European Society of Radiology 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-f2103a9c8179ee198955b24e11dc1597beaab171a205f875e2140230c18b27e63</citedby><cites>FETCH-LOGICAL-c436t-f2103a9c8179ee198955b24e11dc1597beaab171a205f875e2140230c18b27e63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-008-1223-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-008-1223-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19011863$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Enrico, Benedetta</creatorcontrib><creatorcontrib>Suranyi, Pal</creatorcontrib><creatorcontrib>Thilo, Christian</creatorcontrib><creatorcontrib>Bonomo, Lorenzo</creatorcontrib><creatorcontrib>Costello, Philip</creatorcontrib><creatorcontrib>Schoepf, U. Joseph</creatorcontrib><title>Coronary artery plaque formation at coronary CT angiography: morphological analysis and relationship to hemodynamics</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>We aimed to demonstrate that coronary CT angiography (cCTA) can be used to non-invasively study the effect of hemodynamic factors in the pathophysiology of plaque formation. cCTA data of 73 patients were analyzed. All detected plaques were classified according to location (bifurcation, non-branching segment), configuration (eccentric, concentric), orientation (myocardial, lateral, epicardial side of the vessel wall), and composition (calcified, mixed, non-calcified). Bifurcation lesions were further characterized using the Medina classification. Of 382 plaques, 8.1% were in the LM, 46.3% in the LAD, 18.3% in the LCx, and 25.9% in the RCA. Also, 25.1% were completely calcified, 72.3% were mixed, and 2.6% were purely non-calcified. Of the plaques, 51.3% were bifurcation lesions. The most frequent (40%) Medina pattern was 1.1.0 (lesion starts before, extends beyond bifurcation, sparing the side branch). Eighty percent of plaques were eccentric. A significant (p < 0.01) majority (55%) were on the myocardial side, while 17.3% were lateral, and 27.7% epicardial. Of all non-calcified and mixed plaques, 45.1% (p < 0.01) were myocardial, whereas only 14.3% were lateral, 20.6% epicardial, and 19.9% concentric. We conclude that cCTA can non-invasively study the effect of vascular hemodynamics, such as turbulent flow (bifurcations) and low shear stress (myocardial vessel wall), on the distribution and composition of atherosclerotic plaque deposition.</description><subject>Aged</subject><subject>Atherosclerosis</subject><subject>Atherosclerosis - diagnosis</subject><subject>Atherosclerosis - pathology</subject><subject>Blood Vessels - pathology</subject><subject>Calcification</subject><subject>Cardiac</subject><subject>Cardiovascular disease</subject><subject>Catheters</subject><subject>Coronary Angiography - instrumentation</subject><subject>Coronary Angiography - methods</subject><subject>Coronary vessels</subject><subject>Coronary Vessels - pathology</subject><subject>Diagnostic Radiology</subject><subject>Endothelium, Vascular - cytology</subject><subject>Endothelium, Vascular - pathology</subject><subject>Female</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Morphology</subject><subject>Neuroradiology</subject><subject>Patients</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Shear stress</subject><subject>Tomography, X-Ray Computed - instrumentation</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Ultrasound</subject><subject>Vein & artery diseases</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1LxDAQhoMo7vrxA7xI8OKpOpO0m8SbLH6B4EXPIc2mu5W2qUl72H9v1l1ZEDzNwDzvO8y8hFwg3CCAuI0AnEMGIDNkjGf8gEwx5yxDkPkhmYLiMhNK5RNyEuMnACjMxTGZoAJEOeNTMsx98J0Ja2rC4FLpG_M1Olr50Jqh9h01A7W_zPydmm5Z-2Uw_Wp9R1sf-pVv_LK2pkkj06xjHVOzoME1P_q4qns6eLpyrV-sO9PWNp6Ro8o00Z3v6in5eHx4nz9nr29PL_P718zmfDZkFUPgRlmJQjmHSqqiKFnuEBcWCyVKZ0yJAg2DopKicAxzYBwsypIJN-On5Hrr2wefjoqDbutoXdOYzvkxasE5Z4BFkcirP-SnH0O6J2qGUipkM0gQbiEbfIzBVboPdZv-ohH0JhC9DUSnQPQmEM2T5nJnPJatW-wVuwQSwLZATKNu6cJ-8_-u33qNlsc</recordid><startdate>20090401</startdate><enddate>20090401</enddate><creator>Enrico, Benedetta</creator><creator>Suranyi, Pal</creator><creator>Thilo, Christian</creator><creator>Bonomo, Lorenzo</creator><creator>Costello, Philip</creator><creator>Schoepf, U. 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Joseph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary artery plaque formation at coronary CT angiography: morphological analysis and relationship to hemodynamics</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2009-04-01</date><risdate>2009</risdate><volume>19</volume><issue>4</issue><spage>837</spage><epage>844</epage><pages>837-844</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>We aimed to demonstrate that coronary CT angiography (cCTA) can be used to non-invasively study the effect of hemodynamic factors in the pathophysiology of plaque formation. cCTA data of 73 patients were analyzed. All detected plaques were classified according to location (bifurcation, non-branching segment), configuration (eccentric, concentric), orientation (myocardial, lateral, epicardial side of the vessel wall), and composition (calcified, mixed, non-calcified). Bifurcation lesions were further characterized using the Medina classification. Of 382 plaques, 8.1% were in the LM, 46.3% in the LAD, 18.3% in the LCx, and 25.9% in the RCA. Also, 25.1% were completely calcified, 72.3% were mixed, and 2.6% were purely non-calcified. Of the plaques, 51.3% were bifurcation lesions. The most frequent (40%) Medina pattern was 1.1.0 (lesion starts before, extends beyond bifurcation, sparing the side branch). Eighty percent of plaques were eccentric. A significant (p < 0.01) majority (55%) were on the myocardial side, while 17.3% were lateral, and 27.7% epicardial. Of all non-calcified and mixed plaques, 45.1% (p < 0.01) were myocardial, whereas only 14.3% were lateral, 20.6% epicardial, and 19.9% concentric. We conclude that cCTA can non-invasively study the effect of vascular hemodynamics, such as turbulent flow (bifurcations) and low shear stress (myocardial vessel wall), on the distribution and composition of atherosclerotic plaque deposition.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>19011863</pmid><doi>10.1007/s00330-008-1223-3</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Atherosclerosis Atherosclerosis - diagnosis Atherosclerosis - pathology Blood Vessels - pathology Calcification Cardiac Cardiovascular disease Catheters Coronary Angiography - instrumentation Coronary Angiography - methods Coronary vessels Coronary Vessels - pathology Diagnostic Radiology Endothelium, Vascular - cytology Endothelium, Vascular - pathology Female Hemodynamics Humans Imaging Internal Medicine Interventional Radiology Male Medical imaging Medicine Medicine & Public Health Middle Aged Morphology Neuroradiology Patients Radiology Retrospective Studies Risk Shear stress Tomography, X-Ray Computed - instrumentation Tomography, X-Ray Computed - methods Ultrasound Vein & artery diseases |
| title | Coronary artery plaque formation at coronary CT angiography: morphological analysis and relationship to hemodynamics |
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