{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T12:31:42Z","timestamp":1793449902044,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The pathophysiological mechanism behind adverse outcomes associated with ischemia\u2010inducing epicardial coronary stenoses and microcirculatory dysfunction remains unclear. Wall shear stress (WSS) plays an important role in atherosclerotic plaque progression and vulnerability. We aimed to evaluate the relationship between WSS, functionally significant epicardial coronary stenoses, and microcirculatory dysfunction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients undergoing invasive coronary physiology testing were included. Fractional flow reserve, instantaneous wave\u2010free ratio, and the index of microcirculatory resistance were measured. Quantitative coronary angiography was used to obtain the lesion percentage diameter stenosis. Computational fluid dynamics analysis was performed to calculate WSS parameters. Multiple regression analysis was performed to calculate the standardized regression coefficient (\u03b2) for the coronary physiology indices.<\/jats:p>\n            <jats:p xml:lang=\"en\">\n              A total of 107 vessels from 88 patients were included. Fractional flow reserve independently predicted the total area of low WSS (\u03b2=\u22120.44; 95% CI, \u22120.62 to \u22120.25;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and maximum lesion WSS (\u03b2=\u22120.53; 95% CI, \u22120.70 to \u22120.36;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) after adjusting for percentage diameter stenosis and index of microcirculatory resistance. Similarly, instantaneous wave\u2010free ratio also independently predicted the total area of low WSS (\u03b2=\u22120.45; 95% CI, \u22120.62 to \u22120.28;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and maximum lesion WSS (\u03b2=\u22120.58; 95% CI, \u22120.73 to \u22120.43;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). The index of microcirculatory resistance did not predict either low or high WSS.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Fractional flow reserve and instantaneous wave\u2010free ratio independently predicted the total burden of low WSS and maximum lesion WSS in coronary arteries. No relationship was found between microcirculatory dysfunction and WSS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023502","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T10:37:56Z","timestamp":1642588676000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Fractional Flow Reserve and Instantaneous Wave\u2010Free Ratio Predict Pathological Wall Shear Stress in Coronary Arteries: Implications for Understanding the Pathophysiological Impact of Functionally Significant Coronary Stenoses"],"prefix":"10.1161","volume":"11","author":[{"given":"Christopher C. Y.","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Cardiology Concord HospitalUniversity of Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashkan","family":"Javadzadegan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Concord HospitalUniversity of Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences Macquarie University Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2121-0416","authenticated-orcid":false,"given":"Cuneyt","family":"Ada","sequence":"additional","affiliation":[{"name":"Department of Cardiology Concord HospitalUniversity of Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerrett K.","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal Adelaide HospitalUniversity of Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravinay","family":"Bhindi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal North Shore HospitalUniversity of Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1799-1368","authenticated-orcid":false,"given":"William F.","family":"Fearon","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5818-8024","authenticated-orcid":false,"given":"Leonard","family":"Kritharides","sequence":"additional","affiliation":[{"name":"Department of Cardiology Concord HospitalUniversity of Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin K. C.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal Prince Alfred HospitalUniversity of Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6268-4300","authenticated-orcid":false,"given":"Andy S. C.","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Cardiology Concord HospitalUniversity of Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences Macquarie University Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.6.535"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv452"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0807611"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.12.053"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.021824"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl575"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.07.004"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.096438"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.07.075"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.01.023"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.08.019"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009058"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.115.002857"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz230"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-18-00342"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.066"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq259"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00428.2012"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2018.10.023"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.11.005"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-355X(99)80010-9"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccl.2015.06.009"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2010.09.008"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV10I12A249"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc4501.099316"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2017.0393"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199606273342604"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx669"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-9-199305010-00005"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2019.00141"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.023502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:43:13Z","timestamp":1715600593000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.023502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1161\/JAHA.121.023502"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.023502","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2]]},"assertion":[{"value":"2021-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e023502"}}