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In this study, the investigators sought to evaluate the feasibility of estimating external hemodynamic stress acting plaque with the use of invasively measured hemodynamic data from pressure wire pullback tracing.
In addition, the investigators will also evaluate detailed plaque geometry and vulnerability using optical coherence tomography along with the hemodynamic stress.
It has been well known that mechanism of acute coronary syndrome is plaque rupture and occlusion of coronary artery by this plaque rupture. Although current risk assessment for plaque rupture have mainly focused on evaluation of plaque vulnerability. However, according to the general mechanism of material failure, plaque rupture occurs whenever the external hemodynamic stress exceeds the durability of the plaque.
Recently, we evaluated the axial plaque stress, which is axial component of total traction acting on the plaque, and showed that the axial plaque stress possess significantly higher magnitude than previously known wall shear stress.
However, the axial plaque stress in our previous research was measured with computational flow dynamics analysis using coronary artery model from coronary CT angiography.
In this study, we sought to evaluate the feasibility of estimating external hemodynamic stress acting plaque with the use of invasively measured hemodynamic data from pressure wire pullback tracing.
In addition, we will also evaluate detailed plaque geometry and vulnerability using optical coherence tomography along with the hemodynamic stress.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| OCT and Pressure wire pullback tracing | This study is pilot study evaluating the feasibility of invasive measurement and estimation of hemodynamic stress acting on plaque as well as co-registration of hemodynamic data with plaque geometric data, which is obtained by optical coherence tomography |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Device | Procedure | Optical coherence tomography to evaluate plaque morphology and vulnerable features (ex> cap thickness, spotty calcification) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Axial plaque stress (Axial component of total traction acting on the plaque) | up to 1 week | |
| Cap thickness (measured from optical coherent tomography) | Cap thickness measured from optical coherent tomography | up to 1 week |
| Measure | Description | Time Frame |
|---|---|---|
| Wall shear stress (Friction vector on the surface of the plaque) | Friction vector on the surface of the plaque | up to 1 week |
| Proportion of thin cap fibrous atheroma | Plaques with cap thickness < 60um |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with angina pectoris
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Bon-Kwon Koo, MD, PhD | Contact | 82-2-2072-2062 | bkkoo@snu.ac.kr | |
| Joo Myung Lee, MD, MPH | Contact | 82-2-2072-2062 | drone80@hanmail.net |
| Name | Affiliation | Role |
|---|---|---|
| Bon-Kwon Koo, MD, PhD | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Keimyung University Dongsan Medical Center | Daegu | South Korea |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D004864 | Equipment and Supplies |
| D041623 | Tomography, Optical Coherence |
| ID | Term |
|---|---|
| D041622 | Tomography, Optical |
| D061848 | Optical Imaging |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
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|
| Device | Procedure | Resting and hyperemic pressure pullback tracing will be done with motorized pullback system. |
|
|
| up to 1 week |
| Cardiac death and all-cause mortality | Between High-hemodynamic force plaque and Low-hemodynamic force plaque | 1 year |
| Non-fatal target vessel myocardial infarction | Between High-hemodynamic force plaque and Low-hemodynamic force plaque | 1 year |
| Target vessel restenosis | Between High-hemodynamic force plaque and Low-hemodynamic force plaque | 1 year |
| Inje University Ilsan Paik Hospital | Goyang | South Korea |
|
| Seoul National University Hospital | Seoul | South Korea |
|
| Ulsan University Hospital, University of Ulsan College of Medicine | Ulsan | South Korea |
|
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D003933 | Diagnosis |
| D014054 | Tomography |
| D008919 | Investigative Techniques |