Plaque Ruptures Are Related to High Plaque Stress and Strain Conditions: Direct Verification by Using In Vivo OCT Rupture Data and FSI Models

光学相干层析成像 体内 剪应力 纤维帽 流固耦合 拉伤 生物医学工程 医学 材料科学 病理 有限元法 放射科 结构工程 内科学 复合材料 生物 工程类 生物技术
作者
Chen Zhao,Rui Lv,Akiko Maehara,Liang Wang,Zhanqun Gao,Yajing Xu,Xiaoya Guo,Yu Zhu,Mengde Huang,Xiaoguo Zhang,Jian Zhuo Zhu,Bo Yu,Hongzhi Jia,Gary S. Mintz,Dalin Tang
出处
期刊:Arteriosclerosis, Thrombosis, and Vascular Biology [Lippincott Williams & Wilkins]
标识
DOI:10.1161/atvbaha.124.320764
摘要

BACKGROUND: While it has been hypothesized that high plaque stress and strain may be related to plaque rupture, its direct verification using in vivo coronary plaque rupture data and full 3-dimensional fluid-structure interaction models is lacking in the current literature due to difficulty in obtaining in vivo plaque rupture imaging data from patients with acute coronary syndrome. This case-control study aims to use high-resolution optical coherence tomography–verified in vivo plaque rupture data and 3-dimensional fluid-structure interaction models to seek direct evidence for the high plaque stress/strain hypothesis. METHODS: In vivo coronary plaque optical coherence tomography data (5 ruptured plaques, 5 no-rupture plaques) were acquired from patients using a protocol approved by the local institutional review board with informed consent obtained. The ruptured caps were reconstructed to their prerupture morphology using neighboring plaque cap and vessel geometries. Optical coherence tomography–based 3-dimensional fluid-structure interaction models were constructed to obtain plaque stress, strain, and flow shear stress data for comparative analysis. The rank-sum test in the nonparametric test was used for statistical analysis. RESULTS: Our results showed that the average maximum cap stress and strain values of ruptured plaques were 142% (457.70 versus 189.22 kPa; P =0.0278) and 48% (0.2267 versus 0.1527 kPa; P =0.0476) higher than that for no-rupture plaques, respectively. The mean values of maximum flow shear stresses for ruptured and no-rupture plaques were 145.02 dyn/cm 2 and 81.92 dyn/cm 2 ( P =0.1111), respectively. However, the flow shear stress difference was not statistically significant. CONCLUSIONS: This preliminary case-control study showed that the ruptured plaque group had higher mean maximum stress and strain values. Due to our small study size, larger scale studies are needed to further validate our findings.
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