Human coronary plaque wall thickness correlated positively with flow shear stress and negatively with plaque wall stress: an IVUS-based fluid-structure interaction multi-patient study.
Human coronary plaque wall thickness correlated positively with flow shear stress and negatively with plaque wall stress: an IVUS-based fluid-structure interaction multi-patient study.
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DOI：
10.1186/1475-925x-13-32
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发表时间：
2014-03-26
影响因子：
3.9
通讯作者：
Mintz GS
中科院分区：
文献类型：
--
作者：
Fan R;Tang D;Yang C;Zheng J;Bach R;Wang L;Muccigrosso D;Billiar K;Zhu J;Ma G;Maehara A;Mintz GS
动脉粥样硬化斑块的进展和破裂被认为与机械应力条件有关。在本文中，患者特定的在体血管内超声（IVUS）冠状动脉斑块图像数据被用来构建计算模型与流体-结构相互作用（FSI）和循环弯曲，研究斑块壁厚之间的相关性和流动剪切应力和斑块壁应力条件。IVUS数据是在自愿知情同意后从10名患者获得的。在IVUS导管回撤之前获得X射线血管造影照片，以确定冠状动脉狭窄的位置、血管弯曲和心脏运动。在代表心脏收缩效应的模型中指定了循环弯曲。建立三维各向异性流固耦合模型并求解，得到流动剪切应力（FSS）和菌斑壁应力（PWS）值。获得FSS和PWS值用于统计分析。p < 0.05的相关性被认为是显著的。10例患者中9例显示管壁厚度与血流切应力呈正相关。平均Pearson相关性r值为0.278 ± 0.181。10例患者中有9例显示壁厚与斑块壁应力呈负相关。平均Pearson相关性r值为-0.530 ± 0.210。结果表明，斑块血管壁厚度与FSS呈正相关，与PWS呈负相关。基于患者特异性IVUS的建模方法有可能用于研究和识别控制斑块进展和破裂的可能机制，并辅助诊断和干预程序。这代表了一个新的研究方向。需要使用更多患者随访数据进行进一步研究。
Atherosclerotic plaque progression and rupture are believed to be associated with mechanical stress conditions. In this paper, patient-specific in vivo intravascular ultrasound (IVUS) coronary plaque image data were used to construct computational models with fluid-structure interaction (FSI) and cyclic bending to investigate correlations between plaque wall thickness and both flow shear stress and plaque wall stress conditions. IVUS data were acquired from 10 patients after voluntary informed consent. The X-ray angiogram was obtained prior to the pullback of the IVUS catheter to determine the location of the coronary artery stenosis, vessel curvature and cardiac motion. Cyclic bending was specified in the model representing the effect by heart contraction. 3D anisotropic FSI models were constructed and solved to obtain flow shear stress (FSS) and plaque wall stress (PWS) values. FSS and PWS values were obtained for statistical analysis. Correlations with p < 0.05 were deemed significant. Nine out of the 10 patients showed positive correlation between wall thickness and flow shear stress. The mean Pearson correlation r-value was 0.278 ± 0.181. Similarly, 9 out of the 10 patients showed negative correlation between wall thickness and plaque wall stress. The mean Pearson correlation r-value was -0.530 ± 0.210. Our results showed that plaque vessel wall thickness correlated positively with FSS and negatively with PWS. The patient-specific IVUS-based modeling approach has the potential to be used to investigate and identify possible mechanisms governing plaque progression and rupture and assist in diagnosis and intervention procedures. This represents a new direction of research. Further investigations using more patient follow-up data are warranted.