Abstract
BackgroundBlood pressure (BP) is associated with early atherosclerosis and plaque rupture because the BP variability can significantly affect the blood flow velocity and shear stress over the plaque. However, the mechanical response of BP variability to the plaque remains unclear. Therefore, we investigated the correlation between different maximum systolic blood pressure (SBP) and the stress distribution on plaque, as well as the stress over the plaque and blood velocity around the plaque using different BP variations, which are the BP variability in different phases during one cardiac cycle and beat-to-beat BP variability.MethodWe established a two-dimensional artery model with stenosis at the degree of 62.5%. Eight combinations of pulsatile pressure gradients between the inflow and outflow were implemented at the model. Three levels of fibrous cap thickness were taken into consideration to investigate the additional effect on the BP variability. Wall shear stress and stress/strain distribution over the plaque were derived as well as the oscillation shear index (OSI) to analyze the impact of the changing rate of BP.ResultThe stresses at diastole were 2.5% ± 1.8% lower than that at systole under the same pressure drop during one cycle. It was also found that elevated SBP might cause the immediate increment of stress in the present cycle (292% ± 72.3%), but slight reduction in the successive cycle (0.48% ± 0.4%).ConclusionThe stress/strain distribution over the plaque is sensitive to the BP variability during one cardiac cycle, and the beat-to-beat BP variability could cause considerable impact on the progression of atherosclerosis in long-term.
Highlights
Cardiovascular disease (CVD) has become more prevalent in the last decade
The present study is to investigate how the varying continuous Blood pressure (BP) and △P effect on the stress distribution and hemodynamic in the stenotic artery, wall shear stress (WSS), shear stress (SS) and the von Mises stress (VMS) were analyzed
The flow field of the recirculation areas became more complex in larger systolic blood pressure (SBP) condition, and the recovery of the flow appeared to be extended further away from the stenosis
Summary
Cardiovascular disease (CVD) has become more prevalent in the last decade. It is considered to be the major reason for the morbidity and mortality around the world [1]. Evaluation of plaque vulnerability is an effective way to screen the risk of these fatal events. Risk assessment of carotid atherosclerotic plaques is performed by evaluating the degree of luminal stenosis through imaging modalities including intra-vascular ultrasound (IVUS), Ultra-Sound Echo-Color-Doppler (US-ECD), magnetic resonance angiography(MRA), or computed tomography angiography(CTA) [4]. Imaging-based assessment of vulnerable plaque tends to underestimate the risk of significant clinical events since the plaque vulnerability is depending on the morphology and distribution and the composition of the plaque [7]. Blood pressure (BP) is associated with early atherosclerosis and plaque rupture because the BP variability can significantly affect the blood flow velocity and shear stress over the plaque. We investigated the correlation between different maximum systolic blood pressure (SBP) and the stress distribution on plaque, as well as the stress over the plaque and blood velocity around the plaque using different BP variations, which are the BP variability in different phases during one cardiac cycle and beat-to-beat BP variability
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