Necrotic core thickness and positive arterial remodeling index: emergent biomechanical factors for evaluating the risk of plaque rupture
| Autor: | Gérard Finet, Roderic I. Pettigrew, Ahmed M. Gharib, Philippe Tracqui, Jacques Ohayon, Gilles Rioufol, Julie Heroux, Melanie Suzanne Kotys, Daniel A. Herzka, Abdalla Elagha |
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| Přispěvatelé: | Dynacell, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Department of Hemodynamics and Interventional Cardiology, Institut National de la Santé et de la Recherche Médicale (INSERM), DynaCell, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon (HCL) |
| Rok vydání: | 2008 |
| Předmět: |
MESH: Rupture
MESH: Models Cardiovascular Pathology Necrotic core Physiology [SDV]Life Sciences [q-bio] MESH: Ultrasonography Interventional Coronary Artery Disease 02 engineering and technology 030204 cardiovascular system & hematology MESH: Risk Assessment Coronary artery disease 0302 clinical medicine Fibrosis Intravascular ultrasound MESH: Coronary Vessels MESH: Coronary Artery Disease Core (anatomy) MESH: Stress Mechanical medicine.diagnostic_test Fibrous cap Models Cardiovascular Plaque rupture Articles Coronary Vessels MESH: Predictive Value of Tests MESH: Reproducibility of Results medicine.anatomical_structure MESH: Fibrosis Disease Progression MESH: Disease Progression Cardiology and Cardiovascular Medicine medicine.medical_specialty Plaque instability 0206 medical engineering Risk Assessment Necrosis 03 medical and health sciences MESH: Computer Simulation Predictive Value of Tests Physiology (medical) medicine Humans Computer Simulation Ultrasonography Interventional Rupture MESH: Necrosis MESH: Humans business.industry Reproducibility of Results medicine.disease 020601 biomedical engineering Stress Mechanical business |
| Zdroj: | AJP-Heart and Circulatory Physiology AJP-Heart and Circulatory Physiology, American Physiological Society, 2008, 295 (2), pp.H717-27. ⟨10.1152/ajpheart.00005.2008⟩ |
| ISSN: | 1522-1539 0363-6135 |
| DOI: | 10.1152/ajpheart.00005.2008 |
| Popis: | Fibrous cap thickness is often considered as diagnostic of the degree of plaque instability. Necrotic core area (Corearea) and the arterial remodeling index (Remodindex), on the other hand, are difficult to use as clinical morphological indexes: literature data show a wide dispersion of Corearea thresholds above which plaque becomes unstable. Although histopathology shows a strong correlation between Corearea and Remodindex, it remains unclear how these interact and affect peak cap stress (Capstress), a known predictor of rupture. The aim of this study was to investigate the change in plaque vulnerability as a function of necrotic core size and plaque morphology. Capstress value was calculated on 5,500 idealized atherosclerotic vessel models that had the original feature of mimicking the positive arterial remodeling process described by Glagov. Twenty-four nonruptured plaques acquired by intravascular ultrasound on patients were used to test the performance of the associated idealized morphological models. Taking advantage of the extensive simulations, we investigated the effects of anatomical plaque features on Capstress. It was found that: 1) at the early stages of positive remodeling, lesions were more prone to rupture, which could explain the progression and growth of clinically silent plaques and 2) in addition to cap thickness, necrotic core thickness, rather than area, was critical in determining plaque stability. This study demonstrates that plaque instability is to be viewed not as a consequence of fibrous cap thickness alone but rather as a combination of cap thickness, necrotic core thickness, and the arterial remodeling index. |
| Databáze: | OpenAIRE |
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