How does calcification influence plaque vulnerability? Insights from fatigue analysis

Area of Science:

• Cardiovascular Research
• Biomedical Engineering
• Computational Fluid Dynamics

Background:

• Calcification is often linked to cardiovascular disease burden.
• The precise impact of calcification on atherosclerotic plaque vulnerability remains debated.

Purpose of the Study:

• To investigate the influence of calcification on atherosclerotic plaque rupture risk.
• To evaluate how calcification location affects plaque stability and fatigue life.

Main Methods:

• Utilized fatigue rupture analysis and fatigue life calculations.
• Developed an idealized baseline model of an atherosclerotic plaque without calcification.
• Introduced circular calcifications into the fibrous cap to assess their effects on rupture path and fatigue life.

Main Results:

• Calcified cases demonstrated increased fatigue life in 84.0% of instances, with an average increase of up to 11.4%.
• The influence of calcification on fatigue life was localized, with negligible changes observed for rupture paths distant from the calcification.
• Calcifications positioned closer to the lumen or in the middle of the fibrous cap exhibited a more pronounced increase in fatigue life compared to those near the lipid pool or in the shoulder regions.

Conclusions:

• Calcifications may contribute positively to atherosclerotic plaque stability.
• The impact of calcification on plaque stability is confined to a local area.
• Calcifications near the lumen and in the central fibrous cap appear to confer greater stability benefits.