{Reference Type}: Journal Article
{Title}: Relationship of Coronary Angiography-Derived Radial Wall Strain With Functional Significance, Plaque Morphology, and Clinical Outcomes.
{Author}: Yang S;Wang Z;Park SH;Hong H;Li C;Liu X;Chen L;Hwang D;Zhang J;Hoshino M;Yonetsu T;Shin ES;Doh JH;Nam CW;Wang J;Chen S;Tanaka N;Matsuo H;Kubo T;Chang HJ;Kakuta T;Koo BK;Tu S;
{Journal}: JACC Cardiovasc Interv
{Volume}: 17
{Issue}: 1
{Year}: 2024 Jan 8
{Factor}: 11.075
{DOI}: 10.1016/j.jcin.2023.10.003
{Abstract}: <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.