Circulation journal : official journal of the Japanese Circulation Society · 2026
Radial Wall Strain Derived From Coronary Angiography Reflects Plaque Morphology of Future Acute Coronary Syndrome.
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Masuda Mayuka, Toba Takayoshi, Sugizaki Yoichiro, Kawamori Hiroyuki, Hiromasa Takashi, Fujimoto Daichi, Yamamoto Tetsuya, Iwane Seigo, Tsunamoto Hiroshi, Naniwa Shota, Fujii Masayoshi, Sakamoto Yuki, Fukuishi Yuta, Matsuhama Koshi, Higuchi Kotaro, Okamoto Hiroya, Watanabe Nobuhiro, Takata Ken, Yoshida Shotaro, Iwasaki Masamichi, Kozuki Amane, Shite Junya, Takaya Tomofumi, Otake Hiromasa
Аннотация
BACKGROUND: Radial wall strain (RWS) is a potential marker of plaque vulnerability; however, its association with plaque morphology in future acute coronary syndrome (ACS) remains unclear.
METHODS AND RESULTS: We retrospectively enrolled 98 patients with ACS who underwent optical coherence tomography-guided percutaneous coronary intervention and had a prior coronary angiography (CAG) 1 month to 5 years before ACS. RWS was calculated as the maximum percentage change in lumen diameter within a cardiac cycle (RWSmax). Mild-to-intermediate stenotic lesions on the index CAG were classified as culprit lesions (CLs) and non-CLs (NCLs) of ACS. CLs were further categorized as plaque rupture (PR) or erosion (PE). We identified 74 CLs (50 PRs, 24 PEs) and 96 NCLs. Angiographic and physiological parameters were comparable across the groups; however, RWSmaxwas significantly higher in both PRs and PEs than in NCLs (15.8% vs. 12.6%, P<0.001; 14.1% vs. 12.6%, P=0.012, respectively). In Cox regression analysis, RWSmaxwas associated with subsequent PRs (hazard ratio [HR] 1.56; 95% confidence interval [CI] 1.34-1.82; P<0.001) and PEs (HR 1.33; 95% CI 1.05-1.67; P=0.017). Multinomial logistic regression showed that higher RWSmaxfavored PR, lower RWSmaxfavored NCL, and the estimated probability of PE remained low across the RWSmaxspectrum.
CONCLUSIONS: RWSmaxwas independently associated with subsequent PR and PE, with a higher estimated probability of PR than of PE.
METHODS AND RESULTS: We retrospectively enrolled 98 patients with ACS who underwent optical coherence tomography-guided percutaneous coronary intervention and had a prior coronary angiography (CAG) 1 month to 5 years before ACS. RWS was calculated as the maximum percentage change in lumen diameter within a cardiac cycle (RWSmax). Mild-to-intermediate stenotic lesions on the index CAG were classified as culprit lesions (CLs) and non-CLs (NCLs) of ACS. CLs were further categorized as plaque rupture (PR) or erosion (PE). We identified 74 CLs (50 PRs, 24 PEs) and 96 NCLs. Angiographic and physiological parameters were comparable across the groups; however, RWSmaxwas significantly higher in both PRs and PEs than in NCLs (15.8% vs. 12.6%, P<0.001; 14.1% vs. 12.6%, P=0.012, respectively). In Cox regression analysis, RWSmaxwas associated with subsequent PRs (hazard ratio [HR] 1.56; 95% confidence interval [CI] 1.34-1.82; P<0.001) and PEs (HR 1.33; 95% CI 1.05-1.67; P=0.017). Multinomial logistic regression showed that higher RWSmaxfavored PR, lower RWSmaxfavored NCL, and the estimated probability of PE remained low across the RWSmaxspectrum.
CONCLUSIONS: RWSmaxwas independently associated with subsequent PR and PE, with a higher estimated probability of PR than of PE.