Evaluating the Impact of Calcification on Plaque Vulnerability from the Aspect of Mechanical Interaction Between Blood F
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Annals of Biomedical Engineering (Ó 2020) https://doi.org/10.1007/s10439-020-02655-1
Original Article
Evaluating the Impact of Calcification on Plaque Vulnerability from the Aspect of Mechanical Interaction Between Blood Flow and Artery Based on MRI JESSICA BENITEZ,1,3 DAVIDE FONTANAROSA,2,3 JIAQIU WANG,1,3 PHANI KUMARI PARITALA,1,3 TIM MCGAHAN,5 THOMAS LLOYD,6 and ZHIYONG LI 1,4 1
School of Mechanical, Medical and Process Engineering, Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia; 2School of Clinical Sciences, Queensland University of Technology, Brisbane 4000, Australia; 3Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane 4000, Australia; 4School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China; 5Department of Vascular Surgery, Princess Alexandra Hospital, Brisbane 4102, Australia; and 6Department of Radiology, Princess Alexandra Hospital, Brisbane 4102, Australia (Received 10 June 2020; accepted 8 October 2020) Associate Editor Jane Grande-Allen oversaw the review of this article.
Abstract—Acute cerebral ischemic events and thrombosis are associated with the rupture/erosion of carotid atherosclerotic plaques. The aim of the present study was to determine the impact of calcification deposition on the wall shear stress (WSS) and stresses within the plaques using 3D fluid– structure interaction (FSI) models. Six patients with calcified carotid atherosclerosis underwent multisequence magnetic resonance imaging (MRI) and were divided into three groups according to the calcification volume. To evaluate the role of the calcification deposition on the stresses, the calcification content was replaced by lipids and arterial tissue, respectively. By comparing the results from the simulation with calcification, and when changing it to lipids there was a significant increment in the stresses at the fibrous cap (p = 0.004). Instead, by changing it to arterial tissue, there was no significant difference (p = 0.07). The calcification shapes that presented the highest stresses were thin concave arc-shaped (AS1) and thin convex arc-shaped (AS3), with mean stress values of 107 ± 54.2 and 99.6 ± 23.4 kPa, respectively. It was also observed that, the calcification shape has more influence on the level of stress than its distance to the lumen. Higher WSS values were associated with the presence of calcification. Calcification shape plays an important role in producing high stresses in the plaque. This work further clarifies the impact of calcification on plaque vulnerability.
Address correspondence to Zhiyong Li, School of Mechanical, Medical and Process Engineering, Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia. Electronic mail: [email protected]
Keywords—Fluid–structure interaction (FSI), Atherosclerotic plaque, Calcification, Principal stress, Wall shear stress (WSS), Segmentation.
INTRODUCTION Atherosclerosis is the leading cause of morbidity and mortality worldwide, in which
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