Observational studyEuropean heart journal2019
Impact of combined plaque structural stress and wall shear stress on coronary plaque progression, regression, and changes in composition.
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.
What it found
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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.
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.
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Who cites it
48 citing papers in PubMed, 1 synthesis or guideline pooled it, 111 citations in OpenAlex.
- Standards for quantitative assessments by coronary computed tomography angiography (CCTA): An expert consensus document of the society of cardiovascular computed tomography (SCCT).Journal of cardiovascular computed tomographyGuideline
- An MRI-based method to register patient-specific wall shear stress data to histology.PloS one · 2019Trial
- Advancing Coronary Risk Assessment Through Combined Radiomic, Mechanical, and Hemodynamic Analysis.Annals of biomedical engineering · 2026Article
- Explainable ML for ACS culprit plaques: a multidimensional CCTA model highlighting hemodynamic increment.The international journal of cardiovascular imaging · 2026Article
- Experimental comparisons of optical coherence tomography-based versus angiography-based time-averaged wall shear stress estimations.The international journal of cardiovascular imaging · 2026Article
- Transformative biomechanics and mechanobiology breakthroughs shaping the future of health and medicine.Innovation (Cambridge (Mass.)) · 2026Review
- An Open Multifunctional FPGA-Based Pulser/Receiver System for Intravascular Ultrasound (IVUS) Imaging and Therapy.Sensors (Basel, Switzerland) · 2025Article
- Intravascular imaging for acute coronary syndrome.NPJ cardiovascular health · 2025Review
- Advances in the Computational Assessment of Disturbed Coronary Flow and Wall Shear Stress: A Contemporary Review.Journal of the American Heart Association · 2024Review
- A new understanding of coronary curvature and haemodynamic impact on the course of plaque onset and progression.Royal Society open science · 2024Article
- 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 · 2024Article
- Tandem lesions associate with angiographic progression of coronary artery stenoses.International journal of cardiology. Heart & vasculature · 2024Article
- Left main coronary artery morphological phenotypes and its hemodynamic properties.Biomedical engineering online · 2024Article
- Mechanistic insights into the regression of atherosclerotic plaques.Frontiers in physiology · 2024Review
- Biomechanical factors and atherosclerosis localization: insights and clinical applications.Frontiers in cardiovascular medicine · 2024Review
- Coronary Artery Vorticity to Predict Functional Plaque Progression in Participants with Type 2 Diabetes Mellitus.Radiology. Cardiothoracic imaging · 2023Article
- Impact of Radial Wall Strain on Serial Changes in Vascular Physiology in Patients with Intermediate Coronary Stenosis.Reviews in cardiovascular medicine · 2023Article
- Heterogeneous plaque-lumen geometry is associated with major adverse cardiovascular events.European heart journal open · 2023Article
- The diagnostic performance of AccuFFRangio for evaluating coronary artery stenosis under different computational conditions.Quantitative imaging in medicine and surgery · 2023Article
- Validation of hemodynamic stress calculation in coronary computed tomography angiography versus intravascular ultrasound.Quantitative imaging in medicine and surgery · 2023Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
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.
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Registered trials
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.