Abstract
Background: The three-dimensional (3D) geometry of coronary atherosclerotic plaques is associated with plaque growth and the occurrence of coronary artery disease. However, there is a lack of studies on the 3D geometric properties of coronary plaques. We aim to investigate if coronary plaques of different sizes are consistent in geometric properties.Methods: Nineteen cases with symptomatic stenosis caused by atherosclerotic plaques in the left coronary artery were included. Based on attenuation values on computed tomography angiography images, coronary atherosclerotic plaques and calcifications were identified, 3D reconstructed, and manually revised. Multidimensional geometric parameters were measured on the 3D models of plaques and calcifications. Linear and non-linear (i.e., power function) fittings were used to investigate the relationship between multidimensional geometric parameters (length, surface area, volume, etc.). Pearson correlation coefficient (r), R-squared, and p-values were used to evaluate the significance of the relationship. The analysis was performed based on cases and plaques, respectively. Significant linear relationship was defined as R-squared > 0.25 and p < 0.05.Results: In total, 49 atherosclerotic plaques and 56 calcifications were extracted. In the case-based analysis, significant linear relationships were found between number of plaques and number of calcifications (r = 0.650, p = 0.003) as well as total volume of plaques (r = 0.538, p = 0.018), between number of calcifications and total volume of plaques (r = 0.703, p = 0.001) as well as total volume of calcification (r = 0.646, p = 0.003), and between the total volumes of plaques and calcifications (r = 0.872, p < 0.001). In plaque-based analysis, the power function showed higher R-squared values than the linear function in fitting the relationships of multidimensional geometric parameters. Two presumptions of plaque geometry in different growth stages were proposed with simplified geometric models developed. In the proposed models, the exponents in the power functions of geometric parameters were in accordance with the fitted values.Conclusion: In patients with coronary artery disease, coronary plaques and calcifications are positively related in number and volume. Different coronary plaques are consistent in the relationship between geometry parameters in different dimensions.
Highlights
Coronary artery disease is a cardiovascular disease that has been the leading cause of death globally (Malakar et al, 2019)
We investigated the plaque geometry under the following hypothesis: Hypothesis 2.1: The growth of atherosclerotic plaque extends in axial and circumferential directions, where h, R, and r are linearly related, while θ increases toward 2π
We proposed two simplified geometric models of coronary plaques whose geometric properties were in accordance with the measurement results
Summary
Coronary artery disease is a cardiovascular disease that has been the leading cause of death globally (Malakar et al, 2019). With the growth of an atherosclerotic plaque, the stenosis in the affected coronary artery reduces the myocardial blood flow and oxygen supply. Evidence has shown that the geometry of a plaque, which determines the severity of arterial stenosis, is related to the risks of clinical events, including myocardial infarction in patients with CAD (Choi et al, 2015; Lee et al, 2019a). Further investigation of coronary plaque geometry is, recognised as an important pathway toward understanding the pathophysiology and improving the diagnosis and treatment of CAD (Ratiu et al, 2018). The coronary computed tomography angiography (CCTA) images have a high spatial resolution to reflect the geometry and morphology of coronary plaques (Stefanini Giulio and Windecker, 2015). We aim to investigate if coronary plaques of different sizes are consistent in geometric properties
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