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1 NHLBI, Pettigrew's Laboratory, NIH, Bethesda, Maryland, United States
2 Department of Hemodynamics and Interventional Cardiology, Hospices Civils de Lyon and Claude Bernard University, Lyon1, INSERM E0226, Lyon, France
3 Laboratory TIMC-IMAG, DynaCell, University Joseph Fourier, Institut de l Ingenierie et de l Information de Sante (In3S), CNRS UMR 5525, Grenoble, France
* To whom correspondence should be addressed. E-mail: ohayonj2{at}mail.nih.gov.
In a vulnerable plaque (VP), rupture often occurs at a site of high stress within the cap. It is also known that vessels do not become free of stress when all external loads are removed. Previous studies have shown that such residual stress/strain (RS/S) tends to make the stress distribution more uniform throughout the media of a normal artery. However, the influence of RS/S on the wall stress distribution in pathological coronaries remains unclear. The aim of this study was to investigate the effects of RS/S on the biomechanical stability of VPs. RS/S patterns were studied ex vivo in six human vulnerable coronary plaque samples. Since the existence of RS/S can only be assessed by releasing it, the opening angle technique was the experimental approach used to study the geometrical opening configurations of the diseased arteries, producing an arterial wall in a near-zero stress state. Reciprocally, these opening geometries were used in finite element simulations to reconstruct the RS/S distributions in closed arteries. It was found that the RS/S: i) is not negligible, ii) dramatically affects the physiological peak stress amplitude in the thin fibrous cap, iii) spotlights some new high stress areas, and iv) could be a landmark of the lipid core's developmental process within a VP. This study demonstrates that plaque rupture is not to be viewed as a consequence of intravascular pressure alone, but rather of a subtle combination of external loading and intraplaque RS/S.
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J. Ohayon, G. Finet, A. M. Gharib, D. A. Herzka, P. Tracqui, J. Heroux, G. Rioufol, M. S. Kotys, A. Elagha, and R. I. Pettigrew Necrotic core thickness and positive arterial remodeling index: emergent biomechanical factors for evaluating the risk of plaque rupture Am J Physiol Heart Circ Physiol, August 1, 2008; 295(2): H717 - H727. [Abstract] [Full Text] [PDF] |
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