Development, validation and clinical translation of non-invasive coronary endothelial shear stress estimates

This thesis presents a non-invasive methodology to identify areas in coronary arteries that are prone to atherosclerotic plaque growth. A local haemodynamic force, endothelial shear stress (ESS), is estimated using coronary CT scans and computer modelling. ESS has been identified to influence how and where plaques form. Low ESS was found to be consistently associated with plaque progression and high-risk plaque features over time. This framework was validated against clinical and experimental data, confirming its accuracy. Findings of this thesis suggest that CT-derived ESS could enhance early risk assessment in coronary artery disease, offering a practical tool for preventative cardiovascular care.