Three dimensional geometrical and fluid-dynamical analysis of coronary plaque rupture as a cause of acute coronary syndrome versus silent plaque rupture.

2015 Fiscal Year Final Research Report

• Project/Area Number: 25461093
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Nihon University
• Principal Investigator: HIRO Takafumi 日本大学, 医学部, 准教授 (10294638)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Keywords: 急性冠症候群 / 動脈硬化 / プラーク破綻 / 血管内イメージング / 流体力学

Outline of Final Research Achievements

This study compared the geometrical and hemodynamical features between coronary plaque ruptures that provoked acute coronary syndrome(Group A, n=75) and silent plaque ruptures (Group S, n=24) with using 3D intravascular ultrasound images. The shape of rupture orifice was more longitudinal in Group A (Group A vs. Group S: 59% vs. 29%, p=0.012), whereas it was more oval in Group S. The configuration of fibrous cap residuals had a wide variety: 1) shoulder fissure pattern, 2) flow-disturbing fibrous flaps (88% vs. 71%, p=0.047), and 3) fibrous cap bridge. The combination of longitudinal orifice and flow-disturbing flaps was significantly more frequent in Group A than Group S (57% vs. 21%, p=0.002). According to a computer simulation of blood flow, plaque ruptures in Group A had a significant flow disturbance compared to that in Group S. In conclusion, plaque rupture that provokes acute coronary syndrome has specific geometrical and hemodynamic features compared to silent plaque rupture.

Free Research Field

循環器内科学