Localized Elevation of Shear Stress Is Related to Coronary Plaque RuptureA 3-Dimensional Intravascular Ultrasound Study With In-Vivo Color Mapping of Shear Stress Distribution
Yusaku Fukumoto, MD1,
Takafumi Hiro, MD, PhD, FACC1,*,
Takashi Fujii, MD, PhD,
Genta Hashimoto, MD,
Tatsuhiro Fujimura, MD,
Jutaro Yamada, MD, PhD,
Takayuki Okamura, MD, PhD and
Masunori Matsuzaki, MD, PhD, FACC
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
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Figure 2 Reconstruction of the Coronary Lumen Contour
The lumen contours traced from a total of 18 longitudinal intravascular ultrasound images while revolving the plane in increments of 10° were used to reconstruct the whole profile of the coronary lumen. These data were exported into the program of shear stress calculation. At the rupture site, the contour was extrapolated at the orifice of the ulceration cavity (*).
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Figure 3 Representative Case 1: The LAD of a 60-Year-Old Man With UA
(A) The longitudinal intravascular ultrasound image. Plaque rupture was observed at the proximal site of the plaque. (B) Color mapping of the shear stress distribution. A localized elevation of shear stress was observed on the plaque surface (circle). This portion corresponded to the rupture site (*). LAD = left anterior descending coronary artery; UA = unstable angina.
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Figure 4 Representative Case 2: The LAD of a 57-Year-Old Man With AMI
(A) The longitudinal intravascular ultrasound image. Plaque rupture was observed at the proximal site of the plaque. (B) A focal elevation of shear stress was observed on the plaque surface (circle). This portion corresponded to the rupture site (*). AMI = acute myocardial infarction; LAD = left anterior descending coronary artery.
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