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Blood Flow Energy Identifies Coronary Lesions Culprit of Future Myocardial Infarction.

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Title: Blood Flow Energy Identifies Coronary Lesions Culprit of Future Myocardial Infarction.
Authors: Lodi Rizzini, Maurizio1 (AUTHOR), Candreva, Alessandro1,2 (AUTHOR), Mazzi, Valentina1 (AUTHOR), Pagnoni, Mattia3 (AUTHOR), Chiastra, Claudio1 (AUTHOR), Aben, Jean-Paul4 (AUTHOR), Fournier, Stephane3,5 (AUTHOR), Cook, Stephane6 (AUTHOR), Muller, Olivier3 (AUTHOR), De Bruyne, Bernard7 (AUTHOR), Mizukami, Takuya7 (AUTHOR), Collet, Carlos7 (AUTHOR), Gallo, Diego1 (AUTHOR), Morbiducci, Umberto1 (AUTHOR) umberto.morbiducci@polito.it
Source: Annals of Biomedical Engineering. Feb2024, Vol. 52 Issue 2, p226-238. 13p.
Subjects: Myocardial infarction, Computational fluid dynamics, Blood flow, Coronary vasospasm, Rotational flow, Coronary angiography, Shearing force, Kinetic energy
Abstract: The present study establishes a link between blood flow energy transformations in coronary atherosclerotic lesions and clinical outcomes. The predictive capacity for future myocardial infarction (MI) was compared with that of established quantitative coronary angiography (QCA)-derived predictors. Angiography-based computational fluid dynamics (CFD) simulations were performed on 80 human coronary lesions culprit of MI within 5 years and 108 non-culprit lesions for future MI. Blood flow energy transformations were assessed in the converging flow segment of the lesion as ratios of kinetic and rotational energy values (KER and RER, respectively) at the QCA-identified minimum lumen area and proximal lesion sections. The anatomical and functional lesion severity were evaluated with QCA to derive percentage area stenosis (%AS), vessel fractional flow reserve (vFFR), and translesional vFFR (ΔvFFR). Wall shear stress profiles were investigated in terms of topological shear variation index (TSVI). KER and RER predicted MI at 5 years (AUC = 0.73, 95% CI 0.65–0.80, and AUC = 0.76, 95% CI 0.70–0.83, respectively; p < 0.0001 for both). The predictive capacity for future MI of KER and RER was significantly stronger than vFFR (p = 0.0391 and p = 0.0045, respectively). RER predictive capacity was significantly stronger than %AS and ΔvFFR (p = 0.0041 and p = 0.0059, respectively). The predictive capacity for future MI of KER and RER did not differ significantly from TSVI. Blood flow kinetic and rotational energy transformations were significant predictors for MI at 5 years (p < 0.0001). The findings of this study support the hypothesis of a biomechanical contribution to the process of plaque destabilization/rupture leading to MI. [ABSTRACT FROM AUTHOR]
Copyright of Annals of Biomedical Engineering is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Blood Flow Energy Identifies Coronary Lesions Culprit of Future Myocardial Infarction.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lodi+Rizzini%2C+Maurizio%22&quot;&gt;Lodi Rizzini, Maurizio&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Candreva%2C+Alessandro%22&quot;&gt;Candreva, Alessandro&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mazzi%2C+Valentina%22&quot;&gt;Mazzi, Valentina&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pagnoni%2C+Mattia%22&quot;&gt;Pagnoni, Mattia&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chiastra%2C+Claudio%22&quot;&gt;Chiastra, Claudio&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Aben%2C+Jean-Paul%22&quot;&gt;Aben, Jean-Paul&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fournier%2C+Stephane%22&quot;&gt;Fournier, Stephane&lt;/searchLink&gt;&lt;relatesTo&gt;3,5&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cook%2C+Stephane%22&quot;&gt;Cook, Stephane&lt;/searchLink&gt;&lt;relatesTo&gt;6&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Muller%2C+Olivier%22&quot;&gt;Muller, Olivier&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22De+Bruyne%2C+Bernard%22&quot;&gt;De Bruyne, Bernard&lt;/searchLink&gt;&lt;relatesTo&gt;7&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mizukami%2C+Takuya%22&quot;&gt;Mizukami, Takuya&lt;/searchLink&gt;&lt;relatesTo&gt;7&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Collet%2C+Carlos%22&quot;&gt;Collet, Carlos&lt;/searchLink&gt;&lt;relatesTo&gt;7&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gallo%2C+Diego%22&quot;&gt;Gallo, Diego&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Morbiducci%2C+Umberto%22&quot;&gt;Morbiducci, Umberto&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; umberto.morbiducci@polito.it&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Annals+of+Biomedical+Engineering%22&quot;&gt;Annals of Biomedical Engineering&lt;/searchLink&gt;. Feb2024, Vol. 52 Issue 2, p226-238. 13p.
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– Name: Abstract
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  Data: The present study establishes a link between blood flow energy transformations in coronary atherosclerotic lesions and clinical outcomes. The predictive capacity for future myocardial infarction (MI) was compared with that of established quantitative coronary angiography (QCA)-derived predictors. Angiography-based computational fluid dynamics (CFD) simulations were performed on 80 human coronary lesions culprit of MI within 5 years and 108 non-culprit lesions for future MI. Blood flow energy transformations were assessed in the converging flow segment of the lesion as ratios of kinetic and rotational energy values (KER and RER, respectively) at the QCA-identified minimum lumen area and proximal lesion sections. The anatomical and functional lesion severity were evaluated with QCA to derive percentage area stenosis (%AS), vessel fractional flow reserve (vFFR), and translesional vFFR (ΔvFFR). Wall shear stress profiles were investigated in terms of topological shear variation index (TSVI). KER and RER predicted MI at 5 years (AUC = 0.73, 95% CI 0.65–0.80, and AUC = 0.76, 95% CI 0.70–0.83, respectively; p &lt; 0.0001 for both). The predictive capacity for future MI of KER and RER was significantly stronger than vFFR (p = 0.0391 and p = 0.0045, respectively). RER predictive capacity was significantly stronger than %AS and ΔvFFR (p = 0.0041 and p = 0.0059, respectively). The predictive capacity for future MI of KER and RER did not differ significantly from TSVI. Blood flow kinetic and rotational energy transformations were significant predictors for MI at 5 years (p &lt; 0.0001). The findings of this study support the hypothesis of a biomechanical contribution to the process of plaque destabilization/rupture leading to MI. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Annals of Biomedical Engineering is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s10439-023-03362-3
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        Text: English
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      – SubjectFull: Myocardial infarction
        Type: general
      – SubjectFull: Computational fluid dynamics
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      – SubjectFull: Blood flow
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      – SubjectFull: Coronary vasospasm
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      – SubjectFull: Shearing force
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      – SubjectFull: Kinetic energy
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              Text: Feb2024
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