ArticleAtherosclerosis2023
The role of endothelial shear stress, shear stress gradient, and plaque topography in plaque erosion.
Article in Atherosclerosis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 20 citations in OpenAlex.
- Clinical OCT computation-modeled prognosis of coronary plaque progression with validation by fusogenic macrophage nano-targeting.Nano convergence · 2026Article
- Comprehensive risk prediction of acute coronary syndrome by integrating coronary plaque morphology and hemodynamic characteristics.Quantitative imaging in medicine and surgery · 2026Article
- Advancing Coronary Risk Assessment Through Combined Radiomic, Mechanical, and Hemodynamic Analysis.Annals of biomedical engineering · 2026Article
- Sex differences in vascular endothelial function in predicting cardiovascular events in hypertensive patients.Internal and emergency medicine · 2026Article
- Pathogenesis of plaque erosion.Trends in cardiovascular medicine · 2026Review
- Role of biomechanical factors in plaque rupture and erosion: insight from intravascular imaging based computational modeling.NPJ cardiovascular health · 2025Review
- Sensitivity of coronary hemodynamics to vascular structure variations in health and disease.Scientific reports · 2025Article
- Tortuous extracranial arteries contribute to white Matter hyperintensities in aging brains.Frontiers in aging neuroscience · 2025Article
- Risk Factors Favoring Plaque Erosion.Current atherosclerosis reports · 2024Review
- Erosion of the Atheroma: Wicked T Cells at the Culprit Site.Current atherosclerosis reports · 2024Review
- Endothelial Shear Stress Metrics Associate With Proinflammatory Pathways at the Culprit Site of Coronary Erosion.JACC. Basic to translational science · 2024Article
- Linking Physiology and Biology in Plaque Erosion: A Gordian Knot.JACC. Basic to translational science · 2024Article
- High-Resolution Iodine-Enhanced Micro-Computed Tomography of Intact Human Hearts for Detailed Coronary Microvasculature Analyses.Journal of imaging · 2024Article
- Extracellular vesicles originating from the mechanical microenvironment in the pathogenesis and applications for cardiovascular diseases.Regenerative therapy · 2024Review
- Coronary Plaque Erosion: Epidemiology, Diagnosis, and Treatment.International journal of molecular sciences · 2024Review
Corrections and comments
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Authors and funding
17 authors at 12 institutions in 5 countries.
Funding
Abstract
BACKGROUND AND
aimsPlaque erosion is a common underlying cause of acute coronary syndromes. The role of endothelial shear stress (ESS) and endothelial shear stress gradient (ESSG) in plaque erosion remains unknown. We aimed to determine the role of ESS metrics and maximum plaque slope steepness in plaques with erosion versus stable plaques.
methodsThis analysis included 46 patients/plaques from TOTAL and COMPLETE trials and Brigham and Women's Hospital's database who underwent angiography and OCT. Plaques were divided into those with erosion (n = 24) and matched stable coronary plaques (n = 22). Angiographic views were used to generate a 3-D arterial reconstruction, with centerlines merged from angiography and OCT pullback. Local ESS metrics were assessed by computational fluid dynamics. Among plaque erosions, the up- and down-slope (Δ lumen area/frame) was calculated for each culprit plaque.
resultsCompared with stable plaque controls, plaques with an erosion were associated with higher max ESS (8.3 ± 4.8 vs. 5.0 ± 1.9 Pa, p = 0.02) and max ESSG any direction (9.2 ± 7.5 vs. 4.3 ± 3.11 Pa/mm, p = 0.005). Proximal erosion was associated with a steeper plaque upslope while distal erosion with a steeper plaque downslope. Max ESS and Max ESSG any direction were independent factors in the development of plaque erosion (OR 1.32, 95%CI 1.06-1.65, p = 0.014; OR 1.22, 95% CI 1.03-1.45, p = 0.009, respectively).
conclusionsIn plaques with similar luminal stenosis, plaque erosion was strongly associated with higher ESS, ESS gradients, and plaque slope as compared with stable plaques. These data support that ESS and slope metrics play a key role in the development of plaque erosion and may help prognosticate individual plaques at risk for future erosion.
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