Reversed Correlations Between Atherosclerotic Carotid Plaque Progression and Flow Shear Stress/Plaque Wall Stress Based on Past and Current Scan Data: In Vivo MRI-Based 3D FSI Studies

Abstract

It has been well accepted that low and oscillating blood flow shear stresses (LFSS) correlate positively with intimal thickening and atherosclerosis initiation [1,2]. However, the LFSS hypothesis cannot explain why advanced plaques continue to grow under elevated high flow shear stress conditions [3]. For patient tracking studies, plaque progression is often measured by the difference of plaque geometries between two scans (“past” and “current” scans) when medical imaging is used. Mechanical flow shear stress (FSS) and plaque wall stress (PWS) conditions from the two scans may have different correlations with plaque progression. Using 2D structure models based on in vivo magnetic resonance imaging (MRI) human carotid plaques, Tang et al. showed that 18 out of 21 patients had significant negative correlation between plaque progression measured by wall thickness increase (WTI) and plaque wall stress from current scan [3]. The correlation was reversed when plaque wall stress from past scan was used. In this paper, 3D fluid-structure interactions (FSI) models for 32 matched “past-current” scan pairs of human atherosclerotic carotid plaques based on in vivo MRI data were solved and plaque wall stress (PWS) and flow shear stress (FSS) data were obtained to quantify their correlations with plaque progression measured by WTI.