Angiography-derived radial wall strain predicts coronary lesion progression in non-culprit intermediate stenosis  

作　　者：Zhi-Qing WANG Bo XU Chun-Ming LI Chang-Dong GUAN Yue CHANG Li-Hua XIE Su ZHANG Jia-Yue HUANG Patrick W Serruys William Wijns Liang-Long CHEN Sheng-Xian TU 

机构地区：[1]Department of Cardiology,Fujian Heart Medical Center,Fujian Institute of Coronary Heart Disease,Fujian Medical University Union Hospital,Fujian,China [2]Biomedical Instrument Institute,School of Biomedical Engineering,Shanghai Jiao Tong University,Shanghai,China [3]Department of Cardiology,National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China [4]The Lambe Institute for Translational Medicine and Curam,University of Galway,Galway,Ireland

出　　处：《Journal of Geriatric Cardiology》2022年第12期937-948,共12页老年心脏病学杂志（英文版）

基　　金：supported by the National Natural Science Foundation of China(No.82020108015&No.81871460&No.82170333)。

摘　　要：BACKGROUND Intermediate coronary lesions(ICLs)are highly prevalent but ported mixed prognosis.Radial strain has been associated with plaque vulnerability,yet its role in predicting lesion progression is largely unknown.The purpose of this study was to determine the predictive value of angiography-derived radial wall strain(RWS)for progression of untreated non-culprit ICLs.METHODS Post-hoc analysis was conducted in a study cohort including 603 consecutive patients with 808 ICLs identified at index procedure with angiographic follow-up of up to two years.RWS analysis was performed on selected angiographic frames with minimal foreshortening and vessel overlap.Lesion progression was defined as≥20%increase in percent diameter stenosis.RESULTS Lesion progression occurred in 49 ICLs(6.1%)with a median follow-up period of 16.8 months.Maximal RWS(RWSmax),frequently located at the proximal and throat plaque regions,distinguished progressive ICLs from silent ones.The largest area under the curve value of 0.75(95%CI:0.67–0.82,P<0.001)was reached at the optimal RWSmax cutoff value of>12.6%.According to this threshold,178 ICLs were classified as having a high strain pattern.Exposure to a high strain amplitude with RWS_(max)>12.6%was independently associated with an increased risk of lesion progression(adjusted HR=6.82,95%CI:3.67–12.66,P<0.001).CONCLUSIONS Assessment of RWS from coronary angiography is feasible and provides independent prognostic value in patients with untreated ICLs.

关 键 词：CORONARY STENOSIS STRAIN 

分 类 号：R543.3[医药卫生—心血管疾病]