A5021293112- Coronary Interventions and Diagnostics
- Cardiac Imaging and Diagnostics
- Cerebrovascular and Carotid Artery Diseases
- Cardiovascular Disease and Adiposity
- Cardiovascular Health and Disease Prevention
- Acute Myocardial Infarction Research
- Atherosclerosis and Cardiovascular Diseases
- Angiogenesis and VEGF in Cancer
- Mathematical Biology Tumor Growth
- Transplantation: Methods and Outcomes
- Acute Ischemic Stroke Management
- Ultrasound and Hyperthermia Applications
- Antiplatelet Therapy and Cardiovascular Diseases
- Viral Infections and Immunology Research
Brigham and Women's Hospital
2020-2024
Harvard University
2020-2024
University of Cambridge
2023
Northeastern University
2021
Mayo Clinic in Arizona
2020
Anatomical imaging alone of coronary atherosclerotic plaques is insufficient to identify risk future adverse events and guide management non-culprit lesions. Low endothelial shear stress (ESS) high plaque structural (PSS) are associated with events, but individually their predictive value for prediction. We determined whether combining multiple complementary, biomechanical anatomical characteristics improves outcome prediction sufficiently inform clinical decision-making.
Low endothelial shear stress (ESS) and associated adverse biomechanical features stimulate inflammation, contribute to atherogenesis, predispose coronary plaque disruption. The mechanistic links between flow-related hemodynamics inflammatory mediators implicated in erosion, however, remain little explored. We investigated the relationship of high-risk ESS metrics culprit lesion proinflammatory/proatherogenic cells cytokines/chemokines erosion patients with acute syndromes. In eroded plaques,...
Introduction: Plaque natural history is related to local shear stress, and stress has been shown be heterogeneously distributed along the length of individual plaques. We investigated longitudinal spatial heterogeneity plaque progression/regression/quiescence in human coronary arteries. Methods: 591 arteries from 302 patients with disease who presented an acute syndrome PREDICTION study were for patterns non-culprit plaques after 6-10 month FU. Arterial geometry was derived...
Introduction: Risk-stratification of individual coronary plaques is an important goal to detect high-risk likely progress/destabilize, which could inform preemptive intervention prevent adverse cardiac events. IVUS imaging, the current gold standard assess plaque risk, has shown that biomechanical variables, particularly local ESS, contributes critical synergistic prognostic insight when combined with anatomic features. Non-invasive risk assessment CCTA would be invaluable enable broad...
Introduction: The pathobiological mechanisms of coronary plaque erosion are unclear. Low endothelial shear stress (ESS) is a proinflammatory/proatherogenic stimulus associated with progression/destabilization. Intravascular imaging studies suggest that high ESS gradient (low areas adjacent to areas), and steepness upslope/downslope correlate erosion. We investigated the relationship local fluid hemodynamics inflammatory microenvironment at culprit site in patients an acute syndrome....
Introduction: Low endothelial shear stress (ESS) is a pro-atherogenic stimulus associated with coronary plaque development, while high structural (PSS) and its heterogeneity destabilization. Previous studies showed that combining ESS PSS additively predicts progression, but no have determined their ability to predict major adverse cardiovascular events (MACE). We examined whether improves MACE prediction in patients acute syndrome. Methods: baseline ESS, gradient, PSS, index (HI) 22...
Introduction: The role of endothelial shear stress (ESS) in the development coronary plaque erosion is unknown. High ESS gradient (ESSG) has been hypothesized to promote erosion, but no studies have included matched control stable plaques with same minimal and reference lumen area (MLA, RLA, respectively). No examined location (proximal vs distal MLA culprit plaque) related max magnitude upslope downslope obstruction. Aims: (1) compare ESSG between similar that remained stable; (2) among...
Abstract Background Patterns of local endothelial shear stress (ESS) are heterogeneous along the course individual coronary artery plaques. It is unknown how this heterogeneity affects natural history plaque burden (PB) over time. Objectives To determine effect ESS patterns plaques at baseline on subsequent PB progression, regression, and quiescence in human arteries its link to clinical events. Methods 302 patients from PREDICTION study were included study. The was an anatomic followup...