{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T01:23:03Z","timestamp":1794273783554,"version":"4.9.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Evolving evidence suggests that endothelial wall shear stress (ESS) plays a crucial role in the rupture and progression of coronary plaques by triggering biological signalling pathways. We aimed to investigate the patterns of ESS across coronary lesions from non-invasive imaging with coronary computed tomography angiography (CCTA), and to define plaque-associated ESS values in patients with coronary artery disease (CAD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Symptomatic patients with CAD who underwent a clinically indicated CCTA scan were identified. Separate core laboratories performed blinded analysis of CCTA for anatomical and ESS features of coronary atherosclerosis. ESS was assessed using dedicated software, providing minimal and maximal ESS values for each 3\u2005mm segment. Each coronary lesion was divided into upstream, start, minimal luminal area (MLA), end and downstream segments. Also, ESS ratios were calculated using the upstream segment as a reference. From 122 patients (mean age 64 \u00b1 7 years, 57% men), a total of 237 lesions were analyzed. Minimal and maximal ESS values varied across the lesions with the highest values at the MLA segment [minimal ESS 3.97\u2005Pa (IQR 1.93\u20138.92\u2005Pa) and maximal ESS 5.64\u2005Pa (IQR 3.13\u201311.21\u2005Pa), respectively]. Furthermore, minimal and maximal ESS values were positively associated with stenosis severity (P &amp;lt; 0.001), percent atheroma volume (P &amp;lt; 0.001), and lesion length (P \u2264 0.023) at the MLA segment. Using ESS ratios, similar associations were observed for stenosis severity and lesion length.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Detailed behaviour of ESS across coronary lesions can be derived from routine non-invasive CCTA imaging. This may further improve risk stratification.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjci\/jeac095","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T19:10:40Z","timestamp":1652123440000},"page":"1708-1716","source":"Crossref","is-referenced-by-count":7,"title":["Detailed behaviour of endothelial wall shear stress across coronary lesions from non-invasive imaging with coronary computed tomography angiography"],"prefix":"10.1093","volume":"23","author":[{"given":"Inge J","family":"van den Hoogen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jussi","family":"Schultz","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Kiinamyllynkatu 4-8, Turku 20520 , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurrien H","family":"Kuneman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel A","family":"de Graaf","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Kamperidis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Broersen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Image Processing, Leiden University Medical Center , Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Wouter","family":"Jukema","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonis","family":"Sakellarios","sequence":"additional","affiliation":[{"name":"Department of Biomedical Research, FORTH-IMBB , Ioannina , Greece"},{"name":"Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina , Ioannina , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios","family":"Nikopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical School, University of Ioannina , Ioannina , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savvas","family":"Kyriakidis","sequence":"additional","affiliation":[{"name":"Department of Biomedical Research, FORTH-IMBB , Ioannina , Greece"},{"name":"Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina , Ioannina , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina K","family":"Naka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical School, University of Ioannina , Ioannina , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lampros","family":"Michalis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical School, University of Ioannina , Ioannina , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios I","family":"Fotiadis","sequence":"additional","affiliation":[{"name":"Department of Biomedical Research, FORTH-IMBB , Ioannina , Greece"},{"name":"Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina , Ioannina , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teemu","family":"Maaniitty","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Kiinamyllynkatu 4-8, Turku 20520 , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Saraste","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Kiinamyllynkatu 4-8, Turku 20520 , Finland"},{"name":"Heart Center, Turku University Hospital and University of Turku , Turku , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7368-0500","authenticated-orcid":false,"given":"Jeroen J","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Leiden , The Netherlands"},{"name":"Heart Center, Turku University Hospital and University of Turku , Turku , 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