Agreement of wall shear stress distribution between two core laboratories using three-dimensional quantitative coronary angiography

Autor: Shigetaka Kageyama, Vincenzo Tufaro, Ryo Torii, Grigoris V. Karamasis, Roby D. Rakhit, Eric K. W. Poon, Jean-Paul Aben, Andreas Baumbach, Patrick W. Serruys, Yoshinobu Onuma, Christos V. Bourantas
Rok vydání: 2023
Zdroj: The International Journal of Cardiovascular Imaging.
ISSN: 1875-8312
DOI: 10.1007/s10554-023-02872-4
Popis: Wall shear stress (WSS) estimated in models reconstructed from intravascular imaging and 3-dimensional-quantitative coronary angiography (3D-QCA) data provides important prognostic information and enables identification of high-risk lesions. However, these analyses are time-consuming and require expertise, limiting WSS adoption in clinical practice. Recently, a novel software has been developed for real-time computation of time-averaged WSS (TAWSS) and multidirectional WSS distribution. This study aims to examine its inter-corelab reproducibility. Sixty lesions (20 coronary bifurcations) with a borderline negative fractional flow reserve were processed using the CAAS Workstation WSS prototype to estimate WSS and multi-directional WSS values. Analysis was performed by two corelabs and their estimations for the WSS in 3 mm segments across each reconstructed vessel was extracted and compared. In total 700 segments (256 located in bifurcated vessels) were included in the analysis. A high intra-class correlation was noted for all the 3D-QCA and TAWSS metrics between the estimations of the two corelabs irrespective of the presence (range: 0.90–0.92) or absence (range: 0.89–0.90) of a coronary bifurcation, while the ICC was good-moderate for the multidirectional WSS (range: 0.72–0.86). Lesion level analysis demonstrated a high agreement of the two corelabls for detecting lesions exposed to an unfavourable haemodynamic environment (WSS > 8.24 Pa, κ = 0.77) that had a high-risk morphology (area stenosis > 61.3%, κ = 0.71) and were prone to progress and cause events. The CAAS Workstation WSS enables reproducible 3D-QCA reconstruction and computation of WSS metrics. Further research is needed to explore its value in detecting high-risk lesions.
Databáze: OpenAIRE
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