School of Medicine Publications and Presentations
Document Type
Article
Publication Date
2024
Abstract
Background: Many patients with stable angina (SA) having moderate 50% lesions could deteriorate or stay stable for a long time. No present techniques nor test could accurately predict the progression to acute coronary syndrome (ACS) or stabilization of these moderate lesions. Based on the fluid dynamic methodology research, could turbulent flow further damage the plaque and rupture its cap? In contrast, could laminar flow delay the progression of the plaque and keep patients stable for a long period of time?
Methods: Patients with stable angina (SA) were admitted to the intermediate care unit and underwent coronary angiography. Patients were selected if they had a single 50% coronary lesion. The baseline angiographic factors included the flow characteristics: laminar or turbulent, anterograde or retrograde direction, and duration of the turbulent flow across the lesion. The patients were followed up for 2 years. The main clinical endpoints included (A) the development of acute coronary syndrome (ACS), (B) the need for percutaneous coronary interventions (PCI), or (C) persistent stable angina without new clinical or interventional events.
Results:20 patients with moderate lesions were enrolled and followed up for 2 years. The majority of the lesions (18/20= 90%) were located at the mid-segment of the right coronary artery (RCA) or left anterior descending artery. There were six patients with turbulent flow seen at the lesion. 83% of these patients (5/6) developed ACS regardless of the blood pressure or low-density-lipoprotein (LDL) level. If the patients had laminar flow, with well-controlled HTN (SBP< 130mmHg) and LDL cholesterol (
Conclusions: The preliminary results of a pilot study with only 20 patients showed that patients with turbulent flow at the location of a moderate lesion progressed to ACS and PCI. The patients with laminar flow across the lesion remained stable without the need for PCI. Larger randomized studies are needed to confirm the above findings.
Recommended Citation
Nguyen, T., Zuin, M., Le, V., Lam, S. V., Nguyen, H. Q., Dang, H. V., ... & Rigatelli, G. (2024). Preliminary Results of a Study Using Dynamic Angiography in Predicting Progression or Regression of Moderate Severity Lesions. TTU Journal of Biomedical Sciences, 3(1), 1-4. https://doi.org/10.53901/tjbs.2024.03.art01
Publication Title
TTU Journal of Biomedical Sciences
DOI
https://doi.org/10.53901/tjbs.2024.03.art01
Academic Level
resident
Mentor/PI Department
Internal Medicine