Evidence mapPaperPMID 30907406Full record

Observational studyEuropean heart journal2019

Impact of combined plaque structural stress and wall shear stress on coronary plaque progression, regression, and changes in composition.

Charis Costopoulos, Lucas H Timmins, Yuan Huang, Olivia Y Hung, David S Molony, Adam J Brown, Emily L Davis, Zhongzhao Teng, Jonathan H Gillard, Habib Samady and 1 more

Open access · hybridAbstract readComparative StudyObservational Study
In one paragraph

Observational study in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 1 pooled it
11.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 1 synthesis or guideline pooled it, 111 citations in OpenAlex.

  1. Guideline
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  11. High-Frequency, 2-mm-Diameter Forward-Viewing 2-D Array for 3-D Intracoronary Blood Flow Imaging.IEEE transactions on ultrasonics, ferroelectrics, and frequency control · 2024
    Article
  12. Tandem lesions associate with angiographic progression of coronary artery stenoses.International journal of cardiology. Heart & vasculature · 2024
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Charis CostopoulosDivision of Cardiovascular Medicine, University of Cambridge, Level 6, ACCI, Hills Road, Addenbrooke's Hospital, Cambridge, UK.
Lucas H TimminsDivision of Cardiology, Department of Medicine, Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA, USA.
Yuan HuangEPSRC Centre for Mathematical and Statistical Analysis of Multimodal Imaging, University of Cambridge, 20 Clarkson Road, Cambridge, UK.
Olivia Y HungDivision of Cardiology, Department of Medicine, Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA, USA.
David S MolonyWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA, USA.
Adam J BrownDivision of Cardiovascular Medicine, University of Cambridge, Level 6, ACCI, Hills Road, Addenbrooke's Hospital, Cambridge, UK.
Emily L DavisWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA, USA.
Zhongzhao TengDepartment of Radiology, University of Cambridge, Hills Road, Addenbrooke's Hospital, Cambridge, UK.
Jonathan H GillardDepartment of Radiology, University of Cambridge, Hills Road, Addenbrooke's Hospital, Cambridge, UK.
Habib SamadyDivision of Cardiology, Department of Medicine, Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA, USA.
Martin R BennettDivision of Cardiovascular Medicine, University of Cambridge, Level 6, ACCI, Hills Road, Addenbrooke's Hospital, Cambridge, UK.
Georgia Institute of Technology · USAddenbrooke's Hospital · GBUniversity of Cambridge · GBEmory University · US

Funding

British Heart Foundation FS/13/33/30168British Heart Foundation FS/15/26/31441British Heart Foundation PG/18/14/33562
6 · The paper itself

Abstract

aimsThe focal distribution of atherosclerotic plaques suggests that local biomechanical factors may influence plaque development. METHODS AND

resultsWe studied 40 patients at baseline and over 12 months by virtual-histology intravascular ultrasound and bi-plane coronary angiography. We calculated plaque structural stress (PSS), defined as the mean of the maximum principal stress at the peri-luminal region, and wall shear stress (WSS), defined as the parallel frictional force exerted by blood flow on the endothelial surface, in areas undergoing progression or regression. Changes in plaque area, plaque burden (PB), necrotic core (NC), fibrous tissue (FT), fibrofatty tissue, and dense calcium were calculated for each co-registered frame. A total of 4029 co-registered frames were generated. In areas with progression, high PSS was associated with larger increases in NC and small increases in FT vs. low PSS (difference in ΔNC: 0.24 ± 0.06 mm2; P < 0.0001, difference in ΔFT: -0.15 ± 0.08 mm2; P = 0.049). In areas with regression, high PSS was associated with increased NC and decreased FT (difference in ΔNC: 0.15 ± 0.04; P = 0.0005, difference in ΔFT: -0.31 ± 0.06 mm2; P < 0.0001). Low WSS was associated with increased PB vs. high WSS in areas with progression (difference in ΔPB: 3.3 ± 0.4%; P < 0.001) with a similar pattern observed in areas with regression (difference in ΔPB: 1.2 ± 0.4%; P = 0.004). Plaque structural stress and WSS were largely independent of each other (R2 = 0.002; P = 0.001).

conclusionAreas with high PSS are associated with compositional changes consistent with increased plaque vulnerability. Areas with low WSS are associated with more plaque growth in areas that progress and less plaque loss in areas that regress. The interplay of PSS and WSS may govern important changes in plaque size and composition.

Indexed as

Biomechanical PhenomenaCoronary AngiographyCoronary Artery DiseaseCoronary VesselsDisease ProgressionHemodynamicsHumansNecrosisPlaque, AtheroscleroticStress, MechanicalUltrasonography, InterventionalPlaque progressionPlaque regressionPlaque structural stressWall shear stress

Identifiers

PMID30907406
PMCPMC6503452
OpenAlexW2935948552

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.