PubMed · 385935
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M Nakamura, H Tomoike. 1979-06-29. [Coronary circulation].. https://pubmed.ncbi.nlm.nih.gov/385935/
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BACKGROUND: In-stent restenosis by excessive intimal hyperplasia reduces the long-term clinical efficacy of coronary stents. Because shear stress (SS) is related to plaque growth in atherosclerosis, we investigated whether variations in SS distribution are related to variations in neointima formation. METHODS AND RESULTS: In 14 patients, at 6-month follow-up after coronary Wallstent implantation, 3D stent and vessel reconstruction was performed with a combined angiographic and intravascular ultrasound technique (ANGUS). The bare stent reconstruction was used to calculate in-stent SS at implantation, applying computational fluid dynamics. The flow was selected to deliver an average SS of 1.5 N/m(2). SS and neointimal thickness (Th) values were obtained with a resolution of 90 degrees in the circumferential and 2.5 mm in the longitudinal direction. For each vessel, the relationship between Th and SS was obtained by linear regression analysis. Averaging the individual slopes and intercepts of the regression lines summarized the overall relationship. Average Th was 0.44+/-0.20 mm. Th was inversely related to SS: Th=(0.59+/-0.24)-(0.08+/-0.10)xSS (mm) (P<0.05). CONCLUSIONS: These data show for the first time in vivo that the Th variations in Wallstents at 6-month follow-up are inversely related to the relative SS distribution. These findings support a hemodynamic mechanism underlying in-stent neointimal hyperplasia formation.
A multislice real-time imaging technique is described which can provide continuous visualization of the entire left ventricle under resting and stress conditions. Three dynamically adjustable slices containing apical, mid, and base short axis views are imaged 16 times/sec (48 images/sec), with each image providing 3.12 mm resolution over a 20 cm field of view. Initial studies indicate that this technique is useful for the assessment of LV function by providing simultaneous real-time visualization of all 16 wall segments. This technique may also be used for stress LV function and, when used in conjunction with contrast agents, myocardial perfusion imaging. Magn Reson Med 45:371-375, 2001.