Comparison of Angiographically Derived Coronary Radial Wall Strain and Superficial Wall Stress for the Characterization of Plaque Vulnerability

Q: What is the difference between radial wall strain (RWS) and superficial wall stress (SWS) in this study?

RWS estimates radial coronary wall deformation caused by pulsatile blood pressure, while SWS summarizes comprehensive wall deformation arising from both blood pressure and cardiac motion.

Q: How were RWS, SWS, and plaque vulnerability evaluated?

The study retrospectively analyzed concurrent RWS, ΔCBA, SWS, and optical coherence tomography (OCT) imaging in 49 eligible intermediate coronary lesions, then used correlation and multivariate linear regression.

Q: Which plaque indicator showed associations with RWS and SWS?

The lipid-to-cap ratio (LCR) correlated with both maximum RWS (RWSmax) and peak SWS, and remained independently associated with both in multivariate models.

Sep 30, 2026

Uploaded by dabgoudw

Angiography-derived radial wall strain (RWS) reflects radial coronary wall deformation from pulsatile blood pressure, while superficial wall stress (SWS) aggregates wall deformation driven by both blood pressure and cardiac motion. This retrospective study compared RWS and SWS for characterizing plaque vulnerability and assessed how cardiac motion influences RWS. Measurements included RWS, cardiac motion-induced bending angle change (ΔCBA), SWS, and OCT analyses in 49 intermediate coronary lesions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

ORIGINAL ARTICLE Cardiology Journal 2025, Vol. 32, No. 6, 535–545 DOI: 10.5603/cj.101778 Copyright © 2025 Via Medica ISSN 1897–5593 eISSN 1898–018X Comparison of angiographically derived coronary radial wall strain and superficial wall stress for the characterization of plaque vulnerability Zhiqing Wang 1–3*, Jiayue Huang3* , Chunming Li3 , Tianxiao Xu3 , Huihong Hong4 , Xinkai Qu2 , Lianglong Chen 1 , Shengxian Tu 1,3 1Department of Cardiology, Fujian Heart Medical Center, Fujian Medical University Union Hospital, Fuzhou, China 2Department of Cardiology, Huadong Hospital, Fudan University, Shanghai, China 3Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China 4Department of Cardiology, the First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China Abstract Background: Angiography-derived radial wall strain (RWS) estimates the radial coronary wall deformation caused by pulsatile blood pressure, whereas superficial wall stress (SWS) summarizes the comprehensive wall deformation caused by both blood pressure and cardiac motion. This study sought to investigate the difference between RWS and SWS for the association with plaque vulnerability and the impact of cardiac motion on RWS. Methods: Concurrent RWS, cardiac motion-induced bending angle change (ΔCBA), SWS, and optical coherence tomography image analyses were retrospectively performed in 49 eligible intermediate coronary lesions. Correlation and multivariate linear regression analyses were applied to investigate the difference in the correlations of RWS and SWS with plaque characteristics and the impact of ΔCBA on RWS assessment. Results: Lipid-to-cap ratio (LCR), a novel vulnerable plaque indicator, was found to be correlated with both maximum RWS (RWSmax) (r = 0.58, p < 0.001) and peak SWS (r = 0.29, p = 0.041). RWSmax tended to be more relevant to LCR in comparison with peak SWS, albeit statistically nonsignificant (z = 1.75, p = 0.080). With multivariate linear regression, LCR was independently associated with both RWSmax (normalized β = 0.49, p = 0.001) and peak SWS (normalized β = 0.34, p = 0.012), whereas ΔCBA could only affect peak SWS (normalized β = 0.29, p = 0.035). Peak time-averaged SWS showed similar results to peak SWS. Conclusions: RWS tended to be more relevant to plaque vulnerability and less affected by cyclic bending as compared with SWS. (CardiolJ 2025; 32, 6: 535–545) Keywords: radial wall strain, superficial wall stress, bending deformation, plaque vulnerability, lipid-to-cap ratio Address for correspondence: Shengxian Tu, PhD, Med-X Research Institute, Shanghai Jiao Tong University, 1954, Huashan Road, Shanghai 200030, China, tel: +86 2162932631, e-mail: [sxtu@sjtu.edu.cn](sxtu@sjtu.edu.cn) Lianglong Chen, MD, PhD, Department of Cardiology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, China, tel: +86 13950303022, e-mail: [lianglongchen@126.com](lianglongchen@126.com) *These authors contributed equally to this work Submitted: 3.08.2024 Accepted: 30.07.2025 Early publication date: 5.09.2025 This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. [www.cardiologyjournal.org](www.cardiologyjournal.org) 535 Cardiology Journal 2025, Vol. 32, No. 6 Introduction Coronary artery disease remains the leading cause of death globally, mostly ascribed to the onset of acute coronary events [1], of which disruption of an atherosclerotic plaque with a vulnerable phenotype, generally characterized by a large lipid core, thin fibrous cap, as well as active inflammation, represents the major underlying mechanism [2, 3] . Despite

FAQs

What is the difference between radial wall strain (RWS) and superficial wall stress (SWS) in this study?

RWS estimates radial coronary wall deformation caused by pulsatile blood pressure, while SWS summarizes comprehensive wall deformation arising from both blood pressure and cardiac motion.

How were RWS, SWS, and plaque vulnerability evaluated?

The study retrospectively analyzed concurrent RWS, ΔCBA, SWS, and optical coherence tomography (OCT) imaging in 49 eligible intermediate coronary lesions, then used correlation and multivariate linear regression.

Which plaque indicator showed associations with RWS and SWS?

The lipid-to-cap ratio (LCR) correlated with both maximum RWS (RWSmax) and peak SWS, and remained independently associated with both in multivariate models.

Sep 30, 2026

Uploaded by dabgoudw