The development of optical coherence tomography (OCT) has revolutionized our understanding of coronary artery disease. In vivo OCT research has paralleled with advances in computational fluid dynamics, providing additional insights in the various hemodynamic factors influencing plaque growth and stability. Recent OCT studies introduced a new concept of plaque healing in relation to clinical presentation. In addition to known mechanisms of acute coronary syndromes such as plaque rupture and plaque erosion, a new classification of calcified plaque was recently reported. This review will focus on important new insights that OCT has provided in recent years into coronary plaque development, progression, and destabilization, with a focus on the role of local hemodynamics and endothelial shear stress, the layered plaque (signature of previous subclinical plaque destabilization and healing), and the calcified culprit plaque.

光学相干断层扫描 (OCT) 的发展彻底改变了我们对冠状动脉疾病的理解。体内 OCT 研究与计算流体动力学的进步并行，为影响斑块生长和稳定性的各种血流动力学因素提供了额外的见解。最近的 OCT 研究引入了与临床表现相关的斑块愈合的新概念。除了已知的急性冠脉综合征机制如斑块破裂和斑块侵蚀外，最近还报道了钙化斑块的新分类。本综述将重点关注近年来 OCT 在冠状动脉斑块形成、进展和不稳定方面提供的重要新见解，重点是局部血流动力学和内皮剪切应力的作用，