title: Cap inflammation leads to higher plaque cap strain and lower cap stress: An MRI-PET/CT-based FSI modeling approach.
abstract: Plaque rupture may be triggered by extreme stress/strain conditions. Inflammation is also implicated and can be imaged using novel imaging techniques. The impact of cap inflammation on plaque stress/strain and flow shear stress were investigated. A patient-specific MRI-PET/CT-based modeling approach was used to develop 3D fluid-structure interaction models and investigate the impact of inflammation on plaque stress/strain conditions for better plaque assessment. 18FDG-PET/CT and MRI data were acquired from 4 male patients (average age: 66) to assess plaque characteristics and inflammation. Material stiffness for the fibrous cap was adjusted lower to reflect cap weakening causing by inflammation. Setting stiffness ratio (SR) to be 1.0 (fibrous tissue) for baseline, results for SR=0.5, 0.25, and 0.1 were obtained. Thin cap and hypertension were also considered. Combining results from the 4 patients, mean cap stress from 729 cap nodes was lowered by 25.2% as SR went from 1.0 to 0.1. Mean cap strain value for SR=0.1 was 0.313, 114% higher than that from SR=1.0 model. The thin cap SR=0.1 model had 40% mean cap stress decrease and 81% cap strain increase compared with SR=1.0 model. The hypertension SR=0.1 model had 19.5% cap stress decrease and 98.6% cap strain increase compared with SR=1.0 model. Differences of flow shear stress with 4 different SR values were limited (<10%). Cap inflammation may lead to large cap strain conditions when combined with thin cap and hypertension. Inflammation also led to lower cap stress. This shows the influence of inflammation on stress/strain calculations which are closely related to plaque assessment.
authors.affiliation: School of Biological Science and Medical Engineering, Southeast University, Nanjing, China; Mathematical Sciences Department, WPI, Worcester, MA 01609, USA. Electronic address: dtang@wpi.edu.
authors.forename: Dalin
authors.initials: D
authors.lastname: Tang
authors.affiliation: Mathematical Sciences Department, WPI, Worcester, MA 01609, USA; Network Technology Research Institute, China United Network Comm. Co., Ltd., Beijing, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Radiology, Translational and molecular imaging institute, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Sarayu
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Radiology, Translational and molecular imaging institute, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Mani
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA.
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Woodard
authors.affiliation: Department of Radiology, Translational and molecular imaging institute, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Robson
authors.affiliation: Department of Radiology, University of Cambridge, CB2 0QQ, United Kingdom.
authors.forename: Zhongzhao
authors.initials: Z
authors.lastname: Teng
authors.affiliation: Department of Radiology, Translational and molecular imaging institute, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Dweck
authors.affiliation: Department of Radiology, Translational and molecular imaging institute, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Zahi A
authors.initials: ZA
authors.lastname: Fayad
mesh_terms: D000368:Aged; D001167:Arteritis / Q000000981:diagnostic imaging* / Q000473:pathology; D001696:Biomechanical Phenomena; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008955:Models, Cardiovascular; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000473:pathology*; D000072078:Positron Emission Tomography Computed Tomography; D012039:Regional Blood Flow
keywords: Arteriosclerosis; Inflammation; Plaque rupture; Stress; Vulnerable plaque