Longitudinal distribution of mechanical stresses in carotid plaques of symptomatic patients

TY - JOUR

T1 - Longitudinal distribution of mechanical stresses in carotid plaques of symptomatic patients

AU - Thrysøe, Samuel A

AU - Oikawa, Minako

AU - Yuan, Chun

AU - Eldrup, Nikolaj

AU - Klaerke, Anette

AU - Paaske, William P

AU - Falk, Erling

AU - Kim, W Yong

AU - Nygaard, Jens Vinge

PY - 2010

Y1 - 2010

N2 - BACKGROUND AND PURPOSE: Mechanical stress may contribute to plaque rupture in patients with carotid atherosclerosis. We determined longitudinal mechanical stresses in carotid atherosclerotic plaques and compared them with known markers of plaque vulnerability. METHODS: Nineteen symptomatic patients scheduled for carotid endarterectomy underwent carotid MRI with a multicontrast protocol to characterize plaque morphology and geometry. Longitudinal 2-dimensional computational models were generated from the MRI data, and the mechanical stresses were calculated. RESULTS: Peak longitudinal mechanical stresses occurred predominantly in the shoulder regions of the carotid plaque and correlated inversely with fibrous cap thickness (r(s)=-0.61; P=0.01), and increasing degrees of stenosis (r(s)=0.71; P=0.003). Peak stress levels were asymmetrically distributed longitudinally, with 50% occurring proximal to the maximal stenosis, 25% at the point of maximal stenosis, and 25% distal to the maximal stenosis. CONCLUSIONS: The peak longitudinal mechanical stresses in the fibrous caps of symptomatic patients with carotid atherosclerotic stenosis were located at known predilection sites for plaque rupture, suggesting that mechanical stresses may play a role in plaque destabilization.

AB - BACKGROUND AND PURPOSE: Mechanical stress may contribute to plaque rupture in patients with carotid atherosclerosis. We determined longitudinal mechanical stresses in carotid atherosclerotic plaques and compared them with known markers of plaque vulnerability. METHODS: Nineteen symptomatic patients scheduled for carotid endarterectomy underwent carotid MRI with a multicontrast protocol to characterize plaque morphology and geometry. Longitudinal 2-dimensional computational models were generated from the MRI data, and the mechanical stresses were calculated. RESULTS: Peak longitudinal mechanical stresses occurred predominantly in the shoulder regions of the carotid plaque and correlated inversely with fibrous cap thickness (r(s)=-0.61; P=0.01), and increasing degrees of stenosis (r(s)=0.71; P=0.003). Peak stress levels were asymmetrically distributed longitudinally, with 50% occurring proximal to the maximal stenosis, 25% at the point of maximal stenosis, and 25% distal to the maximal stenosis. CONCLUSIONS: The peak longitudinal mechanical stresses in the fibrous caps of symptomatic patients with carotid atherosclerotic stenosis were located at known predilection sites for plaque rupture, suggesting that mechanical stresses may play a role in plaque destabilization.

U2 - 10.1161/STROKEAHA.109.571588

DO - 10.1161/STROKEAHA.109.571588

M3 - Journal article

C2 - 20224059

SN - 0039-2499

VL - 41

SP - 1041

EP - 1043

JO - Stroke

JF - Stroke

IS - 5

ER -