%0 Journal Article
%T Relationship of Coronary Angiography-Derived Radial Wall Strain With Functional Significance, Plaque Morphology, and Clinical Outcomes.
%A Yang S
%A Wang Z
%A Park SH
%A Hong H
%A Li C
%A Liu X
%A Chen L
%A Hwang D
%A Zhang J
%A Hoshino M
%A Yonetsu T
%A Shin ES
%A Doh JH
%A Nam CW
%A Wang J
%A Chen S
%A Tanaka N
%A Matsuo H
%A Kubo T
%A Chang HJ
%A Kakuta T
%A Koo BK
%A Tu S
%J JACC Cardiovasc Interv
%V 17
%N 1
%D 2024 Jan 8
%M 38199753
%F 11.075
%R 10.1016/j.jcin.2023.10.003
%X <B>BACKGROUND: </B>Coronary angiography-derived radial wall strain (RWS) is a newly developed index that can be readily accessed and describes the biomechanical features of a lesion.<BR><B>OBJECTIVE: </B>The authors sought to investigate the association of RWS with fractional flow reserve (FFR) and high-risk plaque (HRP), and their relative prognostic implications.<BR><B>METHODS: </B>We included 484 vessels (351 patients) deferred after FFR measurement with available RWS data and coronary computed tomography angiography. On coronary computed tomography angiography, HRP was defined as a lesion with both minimum lumen area <4 mm2 and plaque burden ≥70%. The primary outcome was target vessel failure (TVF), a composite of target vessel revascularization, target vessel myocardial infarction, or cardiac death.<BR><B>RESULTS: </B>The mean FFR and RWSmax were 0.89 ± 0.07 and 11.2% ± 2.5%, respectively, whereas 27.7% of lesions had HRP, 15.1% had FFR ≤0.80. An increase in RWSmax was associated with a higher risk of FFR ≤0.80 and HRP, which was consistent after adjustment for clinical or angiographic characteristics (all P < 0.05). An increment of RWSmax was related to a higher risk of TVF (HR: 1.23 [95% CI: 1.03-1.47]; P = 0.022) with an optimal cutoff of 14.25%. RWSmax >14% was a predictor of TVF after adjustment for FFR or HRP components (all P < 0.05) and showed a direct prognostic effect on TVF, not mediated by FFR ≤0.80 or HRP in the mediation analysis. When high RWSmax was added to FFR ≤0.80 or HRP, there were increasing outcome trends (all P for trend <0.001).<BR><B>CONCLUSIONS: </B>RWS was associated with coronary physiology and plaque morphology but showed independent prognostic significance.