Mechanism of Provocation of Acute Coronary Syndrome from Coronary Plaque Rupture. A Clinical Study with Intravascular Imaging Modalities and Novel Model of Fluid Dynamics

• Project/Area Number: 16K09481
• 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): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2016: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
• Keywords: 粥腫破綻 / 急性冠症候群 / 動脈硬化 / 流体力学 / 粒子法 / 血栓 / プラーク破綻 / 血管内イメージング / ３次元画像構築 / 流体力学的解析 / 循環器内科

Outline of Final Research Achievements

This study examined fluid-dynamical difference of coronary flow between coronary plaque ruptures with provoking acute coronary syndrome (ACS group) and without (non ACS group). Three-dimensional structure of plaque rupture was obtained by intravascular ultrasound imaging in the two groups. The 3D model was then transferred into a computational fluid-dynamical simulation with using a particle method. It was found that particle velocity around coronary plaque rupture was significantly slower in ACS group than that in non ACS group. These results suggests that blood flow velocity around coronary plaque rupture is a key factor to determine whether the rupture leads to the provocation of ACS.

Academic Significance and Societal Importance of the Research Achievements

急性冠症候群（ACS）の主因は冠動脈粥腫の破綻であるが、易破綻性粥腫は、血管内イメージングによりある程度同定できるようになってきているものの、いざ破綻した段階で、それが実際大きな血栓を形成してACSを発症するのがどんな粥腫で、どんな破綻なのかについては、今まで不明であった。その中で本研究は、血液流速が低下する粥腫の破綻がACSを発症しやすいことを示した点で、学術的意義があると考えられる。この成果を踏まえて、実際にACSを発症しやすい粥腫が発症前に同定できれば、破綻を未然に防ぐことで、生命に関わりうるACSの発症率を下げ、ひいては医療費削減に大きく寄与するものと思われる。

Research Products

• [Journal Article] High shear stress on the coronary arterial wall is related to computed tomography-derived high-risk plaque: a three-dimensional computed tomography and color-coded tissue-characterizing intravascular ultrasonography study (2019)
  • Author(s): Nobuhiro Murata, Takafumi Hiro, Tadateru Takayama, Suguru Migita, Tomoyuki Morikawa, Takehiro Tamaki, Takashi Mineki, Keisuke Kojima, Naotaka Akutsu, Mitsumasa Sudo, Daisuke Kitano, Daisuke Fukamachi, Atsushi Hirayama, Yasuo Okumura
  • Journal Title: Heart and Vessels Volume: 印刷中 Issue: 9 Pages: 1429-1439
  • DOI: 10.1007/s00380-019-01389-y
• [Journal Article] Development of Human-Like Advanced Coronary Plaques in Low-Density Lipoprotein Receptor Knockout Pigs and Justification for Statin Treatment Before Formation of Atherosclerotic Plaques (2016)
  • Author(s): Y. Li, D. Fuchimoto, M. Sudo, H. Haruta, Q.F. Lin, T. Takayama, S. Morita, T. Nochi, S. Suzuki, S. Sembon, M. Nakai, M. Kojima, M. Iwamoto, M. Hashimoto, S. Yoda, S. Kunimoto, T. Hiro, T. Matsumoto, M. Mitsumata, M. Sugitani, S. Saito, A. Hirayama, A. Onishi
  • Journal Title: Journal of American Heart Association Volume: Vol.5 Issue: 4
  • DOI: 10.1161/jaha.115.002779
  • Peer Reviewed / Open Access
• [Presentation] 大動脈 CT による大動脈石灰化病変と不安定プラークの関係；大動脈内視鏡研究 (2019)
  • Author(s): 小嶋 啓介、小山 裕、藤戸 秀聡、大角 彰仁、江渕 康柔、盛川 智之、右田 卓、玉城 貴啓、峯木 隆志、村田 伸弘、阿久津 尚孝、須藤 晃正、北野 大輔、深町 大介、高山 忠輝、廣 高史、平山 篤志、奥村 恭男
  • Organizer: 第29回日本心血管画像動態学会
• [Presentation] Impact of Aortic Atheromatous Plaques Identified by Aortic Angioscopy on One-Year Clinical Events: On Behalf of DREAM-NOGA Registry (2019)
  • Author(s): Keisuke Kojima, Sei Komatsu, Tsunekazu Kakuta, Daisuke Fukamachi, Shigeki Kimura, Hiroyuki Fujii, Masayoshi Matsuura, Kazuoki Dai, Hiroshi Matsuoka, Yasunori Ueda, Yoshiharu Higuch, Tadateru Takayama, Takafumi Hiro, Yasuo Okumura, Atsushi Hirayama, Kazuhisa Kodama.
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] Impact of Wall Shear Stress on Plaque Rupture of Aortic Arch with Computational Fluid Dynamics Model and Non-Obstructive General Angioscopy (2019)
  • Author(s): Keisuke Kojima, Takafumi Hiro, Yutaka Koyama, Akihito Ogaku, Hidesato Fujito, Yasunari Ebuchi, Tomoyuki Morikawa, Suguru Migita, Takehiro Tamaki, Takashi Mineki, Nobuhiro Murata, Naotaka Akutsu, Mitsumasa Sudo, Daisuke Kitano, Daisuke Fukamachi, Tadateru Takayama:2, Atsushi Hirayama, Yasuo Okumura.
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] In Vivo Effect of Aging on the Progression of Aortic Atheromatous Plaque Identified by Non-obstructive General Angioscopy (2019)
  • Author(s): Keisuke Kojima, Takafumi Hiro, Yutaka Koyama, Akihito Ogaku, Hidesato Fujito, Yasunari Ebuchi, Tomoyuki Morikawa, Suguru Migita, Takehiro Tamaki, Takashi Mineki, Nobuhiro Murata, Naotaka Akutsu, Mitsumasa Sudo, Daisuke Kitano, Daisuke Fukamachi, Tadateru Takayama:2, Atsushi Hirayama, Yasuo Okumura.
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] High Shear Stress Derived from Three-dimensional CT Angiography is Related to Periprocedural Myocardial Infarct (2019)
  • Author(s): 村田 伸弘, 廣 高史, 大角 彰仁, 小山 裕, 藤戸 秀聡, 江渕 康柔, 右田 卓, 盛川 智之, 玉城 貴啓, 峯木 隆志, 小嶋 啓介, 阿久津 尚孝, 須藤 晃正, 北野 大輔, 深町 大介, 平山 篤志, 奥村 恭男,
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] 冠動脈3D-CTイメージを用いた流体解析と急性冠症候群の関連性 (2018)
  • Author(s): 村田 伸弘、廣 高史, 盛川 智之, 右田 卓, 峯木 隆志, 玉城 貴啓, 小嶋 啓介, 阿久津 尚孝, 須藤 晃正, 北野 大輔, 深町 大介, 高山 忠輝, 平山 篤志
  • Organizer: 第27回日本心血管インターベンション治療学会
• [Presentation] 生体内における大動脈弁の動脈硬化性変化を評価する血流維持型大動脈内視鏡の臨床的な可能性 (2018)
  • Author(s): 小嶋 啓介, 廣 高史, 高山 忠輝, 盛川 智之, 右田 卓, 玉城 貴啓, 峯木 隆志, 向後 隆章, 阿久津 尚孝, 村田 伸弘, 大島 暢, 須藤 晃正, 春田 裕典, 深町 大介, 平山 篤志
  • Organizer: 第27回日本心血管インターベンション治療学会 神戸 2018.8
• [Presentation] Clinical Feasibility of Non-Obstructive Aortic Angioscopy For Assessing Atherosclerotic Pathology of Human Aortic Valve in Vivo: A Novel Approach. (2018)
  • Author(s): Keisuke Kojima, Tadateru Takayama, Takafumi Hiro, Suguru Migita, Tomoyuki Morikawa , Takehiro Tamaki, Takashi Mineki, Takaaki Kogo, Yoshiaki Yamane, Naotaka Akutsu, Nobuhiro Murata, Toru Oshima, Mitsumasa Sudo, Daisuke Kitano, Daisuke Fukamachi, Hironori Haruta, Atsushi Hirayama.
  • Organizer: American College of Cardiology 2018(ACC.18), 67th Annual Scientific Session
  • Int'l Joint Research
• [Presentation] Effects of Resveratrol on Atherosclerotic Lesions in Watanabe Heritable Hyperlipidemic Rabbit (2018)
  • Author(s): Takafumi Kurosawa, Yuxin Li, Takafumi Hiro, Atsushi Hirayama.
  • Organizer: American College of Cardiology 2018(ACC.18), 67th Annual Scientific Session
  • Int'l Joint Research
• [Presentation] Should the Strategy for Secondary Prevention of Coronary Artery Disease be Different in Diabetic Patients?: Lessons From Studies With Intravascular Imaging Modalities (2017)
  • Author(s): Takafumi Hiro
  • Organizer: the 66th Annual Scientific Session of the American College of Cardiology (ACC.17)
  • Place of Presentation: The Walter E. Washington Convention Center,、Wahington DC
  • Year and Date: 2017-03-17
  • Int'l Joint Research / Invited
• [Presentation] Future Technology of Intravascular Ultrasound and Optical Imaging (2017)
  • Author(s): Takafumi Hiro
  • Organizer: the 66th Annual Scientific Session of the American College of Cardiology (ACC.17)
  • Place of Presentation: The Walter E. Washington Convention Center,、Wahington DC
  • Year and Date: 2017-03-17
  • Int'l Joint Research / Invited
• [Presentation] Effects of DPP4 inhibitor Linagliptin on atherosclerotic lesions in Watanabe Heritable Hyperlipidemic rabbit. (2017)
  • Author(s): Takafumi Kurosawa, Yuxin Li, Takafumi Hiro, Hironori Haruta, Atsushi Hirayama.
  • Organizer: European Society of Cardiology (ESC congress 2017)
  • Int'l Joint Research
• [Presentation] Spatial distribution of macrophage accumulation within coronary arterial wall in diabetic versus non-diabetic patients with acute coronary syndrome: a study with multi-intravascular imaging modalities. (2017)
  • Author(s): Takaaki Kogo, Takafumi Hiro, Takehiro Tamaki, Takashi Mineki, Keisuke Kojima, Yasufumi Yuzawa, Tadateru Takayama, Atsushi Hirayama
  • Organizer: European Society of Cardiology (ESC congress 2017)
  • Int'l Joint Research