Abstract
There is ample evidence that the development of acute coronary syndrome is linked to the presence of lipid-core, necrotic plaque. However, there is little information on the natural history of lipid-core plaques in humans. A close link between structural changes of atherosclerotic plaques over time to the local shear stress conditions in the arterial system has been reported.1 Although low shear stress is recognized for its proatherogenic impact on the endothelium,1 its role in plaque composition, destabilization, and rupture is less clear. The current paradigm postulates that low shear stress is a necessary condition for plaque accumulation. However, once lumen narrowing occurs because of plaque, local shear stress increases.2 We describe an approach that allows studying the interaction of lipid-core plaque accumulation and local shear stress in a correct anatomic 3D reconstruction of coronary arteries in living patients. A 61-year-old man with a history of myocardial infarction and stenting of the right coronary …
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