Abstract
BackgroundStretch is a mechanical parameter, which has been proposed previously to affect the biological activities in different tissues. This study explored its utility in determining plaque vulnerability.MethodsOne hundred and six patients with mild to moderate carotid stenosis were recruited in this study (53 symptomatic and 53 asymptomatic). High resolution, multi-sequence magnetic resonance (MR) imaging was performed to delineate various plaque components. Finite element method was used to predict high stretch concentration within the plaque.ResultsDuring a two-year follow-up, 11 patients in symptomatic group and 3 in asymptomatic group experienced recurrent cerebrovascular events. Plaque stretch at systole and stretch variation during one cardiac cycle was greater in symptomatic group than those in the asymptomatic. Within the symptomatic group, a similar trend was observed in patients with recurrent events compared to those without.ConclusionPlaques with high stretch concentration and large stretch variation are associated with increased risk of future cerebrovascular events.
Highlights
During the last decade we have witnessed a revolution in the imaging-based assessment of atheromatous plaques
While most studies initially used Magnetic resonance (MR) for morphological and functional assessment of plaques, there has been a continued effort towards MR-based biomechanical investigation of the diseased vessel [2] because plaque rupture likely occurs if mechanical loading within the fibrous cap (FC) due to blood pressure and flow exceeds its material strength
Here we explore the relationship of plaque stretch, determined by MR-based patient-specific computational modelling, with subsequent cerebrovascular ischaemic events
Summary
During the last decade we have witnessed a revolution in the imaging-based assessment of atheromatous plaques. The superiority of patient-specific biomechanics originates from its inherent capability to integrate information of plaque architecture and associated mechanical conditions. In the only longitudinal study of its kind, we have previously reported that high structural stresses are associated with subsequent cerebrovascular ischemic events [3]. Plaque stretch has shown promise in preliminary studies [4,5,6,7,8]. With this perspective, here we explore the relationship of plaque stretch, determined by MR-based patient-specific computational modelling, with subsequent cerebrovascular ischaemic events.
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