Journal
CIRCULATION JOURNAL
Volume 74, Issue 11, Pages 2360-2364Publisher
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.CJ-10-0305
Keywords
Atherosclerosis; Biomechanical stresses; Cartoid; MRI; Plaque burden
Categories
Funding
- NIHR Cambridge Biomedical Research Centre
- European Union [FP7]
- Medical Research Council
- Royal College of Surgeons of England
- Medical Research Council [G0800480] Funding Source: researchfish
- National Institute for Health Research [ACF-2010-14-011] Funding Source: researchfish
- MRC [G0800480] Funding Source: UKRI
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Background: Biomechanical stresses play an important role in determining plaque stability. Quantification of these simulated stresses can be potentially used to assess plaque vulnerability and differentiate different patient groups. Methods and Results: 54 asymptomatic and 45 acutely symptomatic patients underwent in vivo multicontrast magnetic resonance imaging (MRI) of the carotid arteries. Plaque geometry used for finite element analysis was derived from in vivo MRI at the sites of maximum and minimum plaque burden. In total, 198 slices were used for the computational simulations. A pre-shrink technique was used to refine the simulation. Maximum principle stress at the vulnerable plaque sites (ie, critical stress) was extracted for the selected slices and a comparison was performed between the 2 groups. Critical stress in the slice with maximum plaque burden is significantly higher in acutely symptomatic patients as compared to asymptomatic patients (median, inter quartile range: 198.0 kPa (119.8-359.0 kPa) vs 138.4 kPa (83.8-242.6 kPa), P=0.04). No significant difference was found in the slice with minimum plaque burden between the 2 groups (196.7 kPa (133.3-282.7 kPa) vs 182.4 kPa (117.2-310.6 kPa), P=0.82). Conclusions: Acutely symptomatic carotid plaques have significantly high biomechanical stresses than asymptomatic plaques. This might be potentially useful for establishing a biomechanical risk stratification criteria based on plaque burden in future studies. (Circ J 2010; 74: 2360-2364)
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