Non-dimensional coronary flow profiling: The new ace in the hole or a tool in search of an application?

Abstract

Atherosclerosis remains the leading cause of morbidity and ortality in the western world [1]. It is usually regarded as systemic disease and several well-identified risk factors (i.e., ypertension, diabetes, hyperlipidemia, and cigarette smoking) ave been implicated in its pathogenesis. Noninvasive imaging of therosclerosis, such as intimal wall thickening and plaque formaion, is routinely available using a variety of imaging techniques. lthough the entire coronary tree is exposed to the effect of the ardiovascular risk factors, atherosclerotic lesions preferentially riginate in areas of disturbedflowassociatedwith low shear stress 2]. It has been shown that genes are differently expressed in areas f undisturbed and disturbed flow [3]. In vitro, shear stress high evels induce atheroprotective endothelial gene expression proles, while a shear stress low level stimulates the expression of n atherogenic phenotype [4]. Despite the increasing evidence that uid dynamical forces play a role in the expression of endothelial enes that are likely involved in atherogenesis, further investigaions are needed to rate these findings at their true value. More nsight into the level and the type of shear stress, and new diagnosic tools to establish the shear stress levels areparticularly required.