Association of coronary shear stress with endothelial function and vascular remodeling in patients with normal or mildly diseased coronary arteries

Keishi Saihara, Shuichi Hamasaki, Hideki Okui, Sadatoshi Biro, Sanemasa Ishida, Akiko Yoshikawa, Tetsuro Kataoka, Yuichi Ninomiya, Etsuko Mizoguchi, Tomoko Ichiki, Yutaka Otsuji, Chuwa Tei

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND: The relationship between coronary remodeling, shear stress and endothelial function remains unclear. OBJECTIVE: The present study investigated the effects of mechanical factors on structure and function of epicardial coronary arteries. METHODS: Patients (group 1: %area stenosis<40%, n=55; or group 2: %area stenosis ≥40%, n=17) with a discrete mildly stenotic lesion (%diameter stenosis<30%) underwent intravascular ultrasound examination of the left anterior descending coronary artery for determination of vessel area, lumen area, plaque area, cross-sectional areas at reference segments, and remodeling index (the ratio of vessel area at the culprit lesion to vessel area at the proximal reference site). Further, vascular reactivity was examined using intracoronary administration of acetylcholine, papaverine, and nitroglycerin. RESULTS: Vessel area significantly correlated with plaque area in both groups (r=0.65, P<0.0001 and r=0.85, P<0.0001). Group 1 showed significantly greater acetylcholine-induced percentage changes in coronary blood flow (67±70 vs. 16±75%, P<0.05) and coronary artery diameter (-7±18 vs.-32±31%, P<0.01) and also significantly smaller coronary wall shear stress (65±27 vs. 81±32 dynes/cm, P<0.05) than group 2. The percentage increase in coronary blood flow induced by acetylcholine was significantly and positively correlated with remodeling index in group 1 (r=0.64, P<0.0001) but not in group 2 (r=-0.03, P=0.90) and was also significantly and positively correlated with coronary wall shear stress in group 1 (r=0.46, P<0.001) but not in group 2 (r=-0.33, P=0.19). CONCLUSIONS: Endothelium-dependent vasodilation in the resistance coronary artery correlates with remodeling via increased wall shear stress when target lesions %area stenosis is <40%.

Original languageEnglish (US)
Pages (from-to)401-407
Number of pages7
JournalCoronary Artery Disease
Volume17
Issue number5
DOIs
StatePublished - Aug 2006
Externally publishedYes

Fingerprint

Coronary Artery Disease
Coronary Vessels
Pathologic Constriction
Acetylcholine
Papaverine
Nitroglycerin
Vasodilation
Endothelium
Blood Vessels
Vascular Remodeling

Keywords

  • Coronary blood flow
  • Endothelial function
  • Intravascular ultrasound
  • Vascular remodeling
  • Wall shear stress

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Association of coronary shear stress with endothelial function and vascular remodeling in patients with normal or mildly diseased coronary arteries. / Saihara, Keishi; Hamasaki, Shuichi; Okui, Hideki; Biro, Sadatoshi; Ishida, Sanemasa; Yoshikawa, Akiko; Kataoka, Tetsuro; Ninomiya, Yuichi; Mizoguchi, Etsuko; Ichiki, Tomoko; Otsuji, Yutaka; Tei, Chuwa.

In: Coronary Artery Disease, Vol. 17, No. 5, 08.2006, p. 401-407.

Research output: Contribution to journalArticle

Saihara, K, Hamasaki, S, Okui, H, Biro, S, Ishida, S, Yoshikawa, A, Kataoka, T, Ninomiya, Y, Mizoguchi, E, Ichiki, T, Otsuji, Y & Tei, C 2006, 'Association of coronary shear stress with endothelial function and vascular remodeling in patients with normal or mildly diseased coronary arteries', Coronary Artery Disease, vol. 17, no. 5, pp. 401-407. https://doi.org/10.1097/00019501-200608000-00001
Saihara, Keishi ; Hamasaki, Shuichi ; Okui, Hideki ; Biro, Sadatoshi ; Ishida, Sanemasa ; Yoshikawa, Akiko ; Kataoka, Tetsuro ; Ninomiya, Yuichi ; Mizoguchi, Etsuko ; Ichiki, Tomoko ; Otsuji, Yutaka ; Tei, Chuwa. / Association of coronary shear stress with endothelial function and vascular remodeling in patients with normal or mildly diseased coronary arteries. In: Coronary Artery Disease. 2006 ; Vol. 17, No. 5. pp. 401-407.
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T1 - Association of coronary shear stress with endothelial function and vascular remodeling in patients with normal or mildly diseased coronary arteries

AU - Saihara, Keishi

AU - Hamasaki, Shuichi

AU - Okui, Hideki

AU - Biro, Sadatoshi

AU - Ishida, Sanemasa

AU - Yoshikawa, Akiko

AU - Kataoka, Tetsuro

AU - Ninomiya, Yuichi

AU - Mizoguchi, Etsuko

AU - Ichiki, Tomoko

AU - Otsuji, Yutaka

AU - Tei, Chuwa

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N2 - BACKGROUND: The relationship between coronary remodeling, shear stress and endothelial function remains unclear. OBJECTIVE: The present study investigated the effects of mechanical factors on structure and function of epicardial coronary arteries. METHODS: Patients (group 1: %area stenosis<40%, n=55; or group 2: %area stenosis ≥40%, n=17) with a discrete mildly stenotic lesion (%diameter stenosis<30%) underwent intravascular ultrasound examination of the left anterior descending coronary artery for determination of vessel area, lumen area, plaque area, cross-sectional areas at reference segments, and remodeling index (the ratio of vessel area at the culprit lesion to vessel area at the proximal reference site). Further, vascular reactivity was examined using intracoronary administration of acetylcholine, papaverine, and nitroglycerin. RESULTS: Vessel area significantly correlated with plaque area in both groups (r=0.65, P<0.0001 and r=0.85, P<0.0001). Group 1 showed significantly greater acetylcholine-induced percentage changes in coronary blood flow (67±70 vs. 16±75%, P<0.05) and coronary artery diameter (-7±18 vs.-32±31%, P<0.01) and also significantly smaller coronary wall shear stress (65±27 vs. 81±32 dynes/cm, P<0.05) than group 2. The percentage increase in coronary blood flow induced by acetylcholine was significantly and positively correlated with remodeling index in group 1 (r=0.64, P<0.0001) but not in group 2 (r=-0.03, P=0.90) and was also significantly and positively correlated with coronary wall shear stress in group 1 (r=0.46, P<0.001) but not in group 2 (r=-0.33, P=0.19). CONCLUSIONS: Endothelium-dependent vasodilation in the resistance coronary artery correlates with remodeling via increased wall shear stress when target lesions %area stenosis is <40%.

AB - BACKGROUND: The relationship between coronary remodeling, shear stress and endothelial function remains unclear. OBJECTIVE: The present study investigated the effects of mechanical factors on structure and function of epicardial coronary arteries. METHODS: Patients (group 1: %area stenosis<40%, n=55; or group 2: %area stenosis ≥40%, n=17) with a discrete mildly stenotic lesion (%diameter stenosis<30%) underwent intravascular ultrasound examination of the left anterior descending coronary artery for determination of vessel area, lumen area, plaque area, cross-sectional areas at reference segments, and remodeling index (the ratio of vessel area at the culprit lesion to vessel area at the proximal reference site). Further, vascular reactivity was examined using intracoronary administration of acetylcholine, papaverine, and nitroglycerin. RESULTS: Vessel area significantly correlated with plaque area in both groups (r=0.65, P<0.0001 and r=0.85, P<0.0001). Group 1 showed significantly greater acetylcholine-induced percentage changes in coronary blood flow (67±70 vs. 16±75%, P<0.05) and coronary artery diameter (-7±18 vs.-32±31%, P<0.01) and also significantly smaller coronary wall shear stress (65±27 vs. 81±32 dynes/cm, P<0.05) than group 2. The percentage increase in coronary blood flow induced by acetylcholine was significantly and positively correlated with remodeling index in group 1 (r=0.64, P<0.0001) but not in group 2 (r=-0.03, P=0.90) and was also significantly and positively correlated with coronary wall shear stress in group 1 (r=0.46, P<0.001) but not in group 2 (r=-0.33, P=0.19). CONCLUSIONS: Endothelium-dependent vasodilation in the resistance coronary artery correlates with remodeling via increased wall shear stress when target lesions %area stenosis is <40%.

KW - Coronary blood flow

KW - Endothelial function

KW - Intravascular ultrasound

KW - Vascular remodeling

KW - Wall shear stress

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