Radial wall strain novel measure of plaque composition and vulnerability in coronary stenosis patients: Study

For this purpose, the researchers analyzed anonymized data from patients with intermediate stenosis who underwent CAG (coronary angiography) and OCT in a core laboratory. The TCFA and LCR were determined automatically on OCT images by an algorithm recently validated based on artificial intelligence. The angiography-derived RWSmax was computed as the lumen diameter's maximum deformation throughout the cardiac cycle, determined as a percentage of the largest lumen diameter.

The study led to the following findings:

• CAG and OCT images from 114 patients (124 vessels) were analyzed. The average time for the analysis of RWSmax was 57 seconds.
• The RWSmax in the interrogated plaques was 12% and corresponded positively with the LCR (r=0.584) and lipidic plaque burden (r=0.411) and negatively with fibrous cap thickness (r= −0.439).
• An RWSmax >12% was an angiographic predictor for an LCR>0.33 (AUC (area under the curve)=0.86) and TCFA (AUC=0.72).
• Lesions with RWSmax >12% had a higher TCFA prevalence (22.0% versus 1.5%), thinner fibrous cap thickness (71 μm versus 101 μm), more significant lipidic plaque burden (23.3% versus 15.4%), and higher maximum LCR (0.41 versus 0.18) compared to lesions with RWSmax ≤12%.

"In patients with intermediate coronary stenosis, angiography-derived RWS was significantly correlated with plaque composition and known OCT features of plaque vulnerability," the researchers concluded.

Reference:

Hong H, Li C, Gutiérrez-Chico JL, Wang Z, Huang J, Chu M, Kubo T, Chen L, Wijns W, Tu S. Radial wall strain: a novel angiographic measure of plaque composition and vulnerability. EuroIntervention. 2022 Sep 8:EIJ-D-22-00537. doi: 10.4244/EIJ-D-22-00537. Epub ahead of print. PMID: 36073027.