Coronary plaque composition influences biomechanical stress and predicts plaque rupture in a morpho-mechanic OCT analysis
| Autor: | Mathias Burgmaier, Sebastian Reith, Enrico Domenico Lemma, Rosalia Dettori, Andrea Milzi, Kathrin Burgmaier, Nikolaus Marx |
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| Rok vydání: | 2020 |
| Předmět: |
Life sciences
biology Male plaque rupture QH301-705.5 Science 0206 medical engineering 02 engineering and technology 030204 cardiovascular system & hematology General Biochemistry Genetics and Molecular Biology Stress (mechanics) Coronary artery disease 03 medical and health sciences 0302 clinical medicine ddc:570 medicine Humans Myocardial infarction Biology (General) Stress concentration Aged Aged 80 and over optical coherence tomography General Immunology and Microbiology Chemistry Biomechanical stress General Neuroscience Fibrous cap Biomechanics Plaque rupture Heart plaque biomechanics General Medicine Anatomy Middle Aged medicine.disease 020601 biomedical engineering Plaque Atherosclerotic medicine.anatomical_structure myocardial infarction Medicine Female plaque vulnerability Stress Mechanical Tomography Optical Coherence coronary artery disease Research Article Human |
| Zdroj: | eLife eLife, Vol 10 (2021) eLife, 10 eLife 10, 1-16 (2021). doi:10.7554/eLife.64020 |
| ISSN: | 2050-084X |
| Popis: | Plaque rupture occurs if stress within coronary lesions exceeds the protection exerted by the fibrous cap overlying the necrotic lipid core. However, very little is known about the biomechanical stress exerting this disrupting force. Employing optical coherence tomography (OCT), we generated plaque models and performed finite-element analysis to simulate stress distributions within the vessel wall in 10 ruptured and 10 non-ruptured lesions. In ruptured lesions, maximal stress within fibrous cap (peak cap stress [PCS]: 174 ± 67 vs. 52 ± 42 kPa, p eLife digest Heart attacks are caused by a blockage in arteries that supply oxygen to the heart. This often happens when fatty deposits (or ‘plaques’) that line blood vessels break off and create a clot. To identify individuals most at risk of this occurring, physicians currently use symptoms, family history, blood tests, imaging and surgical procedures. But better methods are needed. Imaging blockages in the arteries of individuals who died from heart attacks highlighted certain plaque characteristics that increase the risk of a rupture. Further understanding the forces that lead to these fatty deposits breaking off may help scientists to develop improved heart attack prediction methods. Using patient-specific computer simulations, Milzi et al. show it is possible to predict where plaques are most likely to rupture in an individual, based on biomechanical stresses on the deposits in the artery. The models also showed how forces on the external layers of the plaque played a pivotal role in breakages. More research is needed to confirm the results of this study and to develop automated ways for measuring the stress exerted on plaques in the arteries. If that research is successful, biomechanical analyses of artery plaques in routine patient assessments may one day allow physicians to predict heart attacks and provide life-saving preventive care. |
| Databáze: | OpenAIRE |
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