Abstract
BackgroundAtherosclerotic plaque progression and rupture are believed to be associated with mechanical stress conditions. In this paper, patient-specific in vivo intravascular ultrasound (IVUS) coronary plaque image data were used to construct computational models with fluid-structure interaction (FSI) and cyclic bending to investigate correlations between plaque wall thickness and both flow shear stress and plaque wall stress conditions.MethodsIVUS data were acquired from 10 patients after voluntary informed consent. The X-ray angiogram was obtained prior to the pullback of the IVUS catheter to determine the location of the coronary artery stenosis, vessel curvature and cardiac motion. Cyclic bending was specified in the model representing the effect by heart contraction. 3D anisotropic FSI models were constructed and solved to obtain flow shear stress (FSS) and plaque wall stress (PWS) values. FSS and PWS values were obtained for statistical analysis. Correlations with p < 0.05 were deemed significant.ResultsNine out of the 10 patients showed positive correlation between wall thickness and flow shear stress. The mean Pearson correlation r-value was 0.278 ± 0.181. Similarly, 9 out of the 10 patients showed negative correlation between wall thickness and plaque wall stress. The mean Pearson correlation r-value was -0.530 ± 0.210.ConclusionOur results showed that plaque vessel wall thickness correlated positively with FSS and negatively with PWS. The patient-specific IVUS-based modeling approach has the potential to be used to investigate and identify possible mechanisms governing plaque progression and rupture and assist in diagnosis and intervention procedures. This represents a new direction of research. Further investigations using more patient follow-up data are warranted.
Highlights
Assessing atherosclerotic plaque vulnerability based on limited in vivo patient data has been a major challenge in cardiovascular research and clinical practice [1,2,3,4,5,6,7]
Parallel to histology-based atherosclerotic plaque classifications introduced by American Heart Association (AHA) [19,20,21], based on in vivo image data and computational modeling, we have introduced morphology- and stress-based plaque vulnerability indices which provide quantitative plaque assessment (Table 1 and Figure 1) [22]
The X-ray angiogram (Allura Xper FD10 System, Philips, Bothel, WA) was obtained prior to the pullback of the intravascular ultrasound (IVUS) catheter to determine the location of the coronary artery stenosis, vessel curvature and its cyclic bending caused by heart contraction
Summary
Assessing atherosclerotic plaque vulnerability based on limited in vivo patient data has been a major challenge in cardiovascular research and clinical practice [1,2,3,4,5,6,7]. Parallel to histology-based atherosclerotic plaque classifications introduced by American Heart Association (AHA) [19,20,21], based on in vivo image data and computational modeling, we have introduced morphology- and stress-based plaque vulnerability indices which provide quantitative plaque assessment (Table 1 and Figure 1) [22] Knowledge of those associations may be helpful for a better understanding of plaque progression and rupture process and for diagnosis and prevention of atherosclerosis-related cardiovascular diseases. Patient-specific in vivo intravascular ultrasound (IVUS) coronary plaque image data were used to construct computational models with fluid-structure interaction (FSI) and cyclic bending to investigate correlations between plaque wall thickness and both flow shear stress and plaque wall stress conditions
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