Abstract

Atherosclerotic plaque rupture is a catastrophic event that contributes to mortality and long-term disability. A better understanding of the plaque mechanical behavior is essential for the identification of vulnerable plaques pre-rupture. Plaque is subjected to a natural dynamic mechanical environment under hemodynamic loading. Therefore, it is important to understand the mechanical response of plaque tissue under cyclic loading conditions. Moreover, experimental data of such mechanical properties are fundamental for more clinically relevant biomechanical modeling and numerical simulations for risk stratification. This study aims to experimentally and numerically characterize the stress-relaxation and cyclic mechanical behavior of carotid plaque tissue. Instron microtester equipped with a custom-developed setup was used for the experiments. Carotid plaque samples excised at endarterectomy were subjected to uniaxial tensile, stress-relaxation, and cyclic loading protocols. Thirty percent of the underlying load level obtained from the uniaxial tensile test results was used to determine the change in mechanical properties of the tissue over time under a controlled testing environment (Control tests). The stress-relaxation test data was used to calibrate the hyperelastic (neo-Hookean, Ogden, Yeoh) and linear viscoelastic (Prony series) material parameters. The normalized relaxation force increased initially and slowly stabilized toward the end of relaxation phase, highlighting the viscoelastic behavior. During the cyclic tests, there was a decrease in the peak force as a function of the cycle number indicating mechanical distension due to repeated loading that varied with different frequencies. The material also accumulated residual deformation, which increased with the cycle number. This trend showed softening behavior of the samples. The results of this preliminary study provide an enhanced understanding of in vivo stress-relaxation and cyclic behavior of the human atherosclerotic plaque tissue.

Highlights

  • Atherosclerosis is a chronic inflammatory disease characterized by hardening or narrowing of the arteries (Ross, 1999)

  • Carotid plaque tissue samples were subjected to uniaxial tensile test, control test, stress-relaxation test and cyclic loading test protocols

  • The time-dependent mechanical response of the carotid plaque tissue was investigated by applying cyclic loading under physiological temperature and hydration medium

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Summary

Introduction

Atherosclerosis is a chronic inflammatory disease characterized by hardening or narrowing of the arteries (Ross, 1999). Carotid artery disease is responsible for 25% of ischemic strokes (Levy et al, 2008) occurring due to plaque rupture in lesions characterized by a thin fibrous cap covering a large necrotic core. Luminal stenosis is a key feature of atherosclerosis and is traditionally assessed using angiographic techniques. The majority of the plaques that cause acute events are not highly stenotic, because the artery undergoes positive remodeling before the plaque encroaches into the lumen (Glagov et al, 1987). Plaque content can be considered more critical than plaque size (Shah, 2003; Corti et al, 2004) and is responsible for life-threatening events. Despite advancements in treatment and management procedures, stroke remains the leading cause of mortality and long-term morbidity in developed countries (Benjamin et al, 2018)

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