A parametric study of the effect of 3D plaque shape on local hemodynamics and implications for plaque instability

Area of Science:

• Cardiovascular Research
• Biomedical Engineering
• Computational Fluid Dynamics

Background:

• Heart attacks often result from vulnerable plaque rupture, leading to coronary artery blockage.
• Detecting these unstable plaques noninvasively before rupture is a significant clinical challenge.
• Hemodynamic factors like wall shear stress (WSS) and inflammation influence plaque instability.

Purpose of the Study:

• To develop a computational workflow for studying the impact of 3D plaque geometry on hemodynamics and plaque instability.
• To enable comprehensive parametric analysis of plaque shape effects on cardiovascular events.
• To identify potential noninvasive markers for vulnerable plaque detection.

Main Methods:

• Created parameterized 3D plaque models within patient-specific coronary arteries using NURBS.
• Simulated blood flow using Navier-Stokes solver within an isogeometric finite-element analysis framework.
• Quantified near-wall hemodynamics (WSS, WSSG) and estimated VCAM-1 distribution.

Main Results:

• Proximal eccentric plaques showed the most vulnerable combination of high WSS and positive WSSG.
• The presence of multiple lesions was associated with increased rupture risk.
• Computational tool linked specific geometric features to hemodynamic instability.

Conclusions:

• The developed computational workflow can analyze 3D plaque shape effects on hemodynamics and instability.
• Specific plaque morphologies, like proximally skewed eccentric plaques, are identified as high-risk.
• This approach could lead to noninvasive methods for detecting vulnerable plaques, aiding in heart attack prevention.