title: Higher critical plaque wall stress in patients who died of coronary artery disease compared with those who died of other causes: a 3D FSI study based on ex vivo MRI of coronary plaques.
abstract: Mechanical forces play an important role in the rupture of vulnerable plaques. This process is often associated with cardiovascular syndromes, such as heart attack and stroke. In this study, magnetic resonance imaging (MRI)-based models were used to investigate the association between plaque wall stress (PWS) and coronary artery disease (CAD). Ex vivo MRI data of coronary plaques from 12 patients were used to construct 12 three-dimensional (3D) fluid-structure interaction (FSI) computational models. Six of the patients had died from CAD and six had died from non-CAD causes. PWS was assessed using all nodal points on the lumen surface of each plaque. The maximum PWS from all possible vulnerable sites of each plaque was defined as the 3D critical plaque wall stress (CPWS). Mean 3D CPWS in the CAD group was 94.3% higher than that in the non-CAD group (265.6 vs. 136.7 kPa, P=0.0029). There was no statistically significant difference in global maximum plaque wall stress (GMPWS) between the two groups (P=0.347). There was also no statistically significant difference in plaque burden between the CAD group (84.4±5%) and the non-CAD group (82.0±8%, P=0.552). The results indicate that plaques from patients who died from CAD were associated with higher CPWS compared with those from patients who died from non-CAD causes. With further validation, analysis of CPWS may prove to be an important component in assessment of plaque vulnerability.
authors.affiliation: School of Mathematical Sciences, Xiamen University, 422 South Siming Road, Xiamen, Fujian 361005, China; Department of Mathematical Sciences, Worcester Polytechnic Institute, MA 01609, USA. Electronic address: xhuang@xmu.edu.cn.
authors.forename: Xueying
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Mathematical Sciences, Worcester Polytechnic Institute, MA 01609, USA; China United Network Communications Co., Ltd., Beijing 100048, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Yang
authors.affiliation: Mallinkcrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Cardiovascular Division, Washington University, St. Louis, MO 63110, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Bach
authors.affiliation: Mallinkcrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA.
authors.forename: David
authors.initials: D
authors.lastname: Muccigrosso
authors.affiliation: Mallinkcrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA.
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Woodard
authors.affiliation: Department of Mathematical Sciences, Worcester Polytechnic Institute, MA 01609, USA.
authors.forename: Dalin
authors.initials: D
authors.lastname: Tang
mesh_terms: D003324:Coronary Artery Disease / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D058226:Plaque, Atherosclerotic / Q000503:physiopathology*
keywords: Coronary artery disease; Fluid structure interactions; Magnetic resonance imaging; Stress; Vulnerable plaque