| Effect of endothelial shear stress on the progression of coronary artery disease, vascular remodeling, and in-stent restenosis in humans: in vivo 6-month follow-up study. | |
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MedLine Citation:
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PMID: 12860915 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Native atherosclerosis and in-stent restenosis are focal and evolve independently. The endothelium controls local arterial responses by transduction of shear stress. Characterization of endothelial shear stress (ESS) may allow for prediction of progression of atherosclerosis and in-stent restenosis. METHODS AND RESULTS: By using intracoronary ultrasound, biplane coronary angiography, and measurement of coronary blood flow, we represented the artery in accurate 3D space and determined detailed characteristics of ESS and arterial wall/plaque morphology. Patients who underwent stent implantation and who had another artery with luminal obstruction <50% underwent intravascular profiling initially and after 6-month follow-up. Twelve arteries in 8 patients were studied: 6 native and 6 stented arteries. In native arteries, regions of abnormally low baseline ESS exhibited a significant increase in plaque thickness and enlargement of the outer vessel wall, such that lumen radius remained unchanged (outward remodeling). Regions of physiological ESS showed little change. Regions with increased ESS exhibited outward remodeling with normalization of ESS. In stented arteries, there was an increase in intima-medial thickness, a decrease in lumen radius, and an increase in ESS at all levels of baseline ESS. CONCLUSIONS: The present study represents the first experience in humans relating ESS to subsequent outcomes in native and stented arteries. Regions of low ESS develop progressive atherosclerosis and outward remodeling, areas of physiological ESS remain quiescent, and areas of increased ESS exhibit outward remodeling. ESS may have a limited role in in-stent restenosis. This technology can predict areas of minor plaque likely to exhibit progression of atherosclerosis. |
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Authors:
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Peter H Stone; Ahmet U Coskun; Scott Kinlay; Maureen E Clark; Milan Sonka; Andreas Wahle; Olusegun J Ilegbusi; Yerem Yeghiazarians; Jeffrey J Popma; John Orav; Richard E Kuntz; Charles L Feldman |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S. Date: 2003-07-14 |
Journal Detail:
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Title: Circulation Volume: 108 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-07-29 Completed Date: 2003-09-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 438-44 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, Mass 02115, USA. pstone@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Blood Flow Velocity Blood Vessel Prosthesis Implantation / adverse effects Coronary Angiography Coronary Artery Disease / diagnosis, physiopathology*, surgery Coronary Circulation Coronary Restenosis / diagnosis, etiology, physiopathology* Coronary Vessels / surgery, ultrasonography Disease Progression Endothelium, Vascular / physiopathology* Feasibility Studies Female Follow-Up Studies Humans Imaging, Three-Dimensional Male Middle Aged Pilot Projects Stents* / adverse effects Stress, Mechanical Treatment Outcome Ultrasonography, Interventional Vascular Patency |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL63373/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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