Key result
Low wall shear stress was associated with higher wall thickness change in plaque-free sectors (p<0.001), while high mechanical wall stress was associated with higher change in plaque sectors (p<0.05).
Why the study?
Although the association of wall shear stress with coronary artery disease is well studied, the role of mechanical wall stress has been largely overlooked.
p-value: p=<0.001
In-silico modeling suggests wall shear stress drives early plaque formation, whereas mechanical wall stress drives the progression of existing plaques.
BACKGROUND AND OBJECTIVE: Although the association of wall shear stress (WSS) with coronary artery disease has been well studied, that of mechanical wall stress (MWS) is mainly overlooked. In this study, we performed in-silico artery-specific modeling to investigate the involvement of both MWS and WSS in coronary artery disease. METHODS: Fifteen coronary arteries from five adult familial hypercholesterolemic pigs were imaged by coronary computed tomography angiography, intravascular ultrasound, and optical coherence tomography at three time points (3, 9, and 12 months). Local WSS and MWS in 3 mm/45° sectors were determined using artery-specific computational models. The relationship of WSS and MWS with wall thickness change (ΔWT) over time was statistically analyzed using Generalized Linear Mixed models. RESULTS: A positive ΔWT was measured in all sectors, where plaque sectors presented a greater ΔWT rate compared to plaque-free sectors. In plaque-free sectors, low WSS was associated with a higher ΔWT rate (p < 0.001). In plaque sectors, high MWS was associated with a higher ΔWT rate (p < 0.05), where ΔWT rate was, although slightly, even greater in the plaque sectors with lipid-rich necrotic core (p < 0.05). CONCLUSIONS: Our results from in-silico coronary-specific models suggest that WSS and MWS may play a dominant role at different stages of coronary artery disease. WSS may be more critical in the early stages of plaque formation while MWS might have greater significance in the progression of existing plaques.
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Tziotziou et al. (2025) studied Coronary artery disease (n=5). Mechanical wall stress and wall shear stress was evaluated on Wall thickness change (ΔWT) over time (p=<0.001). Low wall shear stress was associated with higher wall thickness change in plaque-free sectors (p<0.001), while high mechanical wall stress was associated with higher change in plaque sectors (p<0.05).
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