Advanced Human Coronary Plaque Wall Thickness Correlates Positively With Flow Shear Stress and Negatively With Plaque Wall Stress: An IVUS-Based FSI Study

Abstract

Atherosclerotic plaque progression is believed to be associated with low and oscillating flow shear stress conditions [1–3]. In vivo image-based coronary plaque modeling papers are relatively rare because clinical recognition of vulnerable coronary plaques has remained challenging [3–4]. Samady et al. [3] published their seminal patient follow-up coronary plaque progression study and indicated that flow shear stress (FSS) was associated with plaque progression and remodeling. We have published results based on follow-up studies showing that advanced carotid plaque had positive correlation with flow shear stress and negative correlation with plaque wall stress (PWS) [4]. In this paper, patient-specific intravascular ultrasound (IVUS)-based coronary plaque models with fluid-structure interaction (FSI), on-site pressure and ex vivo biaxial mechanical testing of human coronary plaque material properties were constructed to obtain flow shear stress and plaque wall stress data from six patients to investigate possible associations between vessel wall thickness and both flow shear stress and plaque wall stress conditions.