Plaque Ruptures Are Related to High Plaque Stress and Strain Conditions: Direct Verification by Using In Vivo OCT...

Area of Science:

• Cardiovascular Research
• Biomedical Engineering
• Medical Imaging

Background:

• Hypothesized link between high plaque stress/strain and plaque rupture.
• Lack of in vivo verification due to imaging data challenges.
• Difficulty in obtaining in vivo plaque rupture imaging data from acute coronary syndrome patients.

Purpose of the Study:

• To seek direct evidence for the high plaque stress/strain hypothesis.
• Utilize high-resolution optical coherence tomography (OCT)-verified in vivo plaque rupture data.
• Employ 3-dimensional fluid-structure interaction (FSI) models for analysis.

Main Methods:

• Acquired OCT data from patients with ruptured (n=5) and non-ruptured (n=5) plaques.
• Reconstructed ruptured caps to prerupture morphology.
• Constructed OCT-based 3D FSI models to compute stress, strain, and shear stress.

Main Results:

• Ruptured plaques showed significantly higher maximum cap stress (142% increase) and strain (48% increase) versus non-ruptured plaques.
• Average maximum stress: 457.70 kPa (ruptured) vs. 189.22 kPa (non-ruptured).
• Average maximum strain: 0.2267 kPa (ruptured) vs. 0.1527 kPa (non-ruptured).
• Flow shear stress difference was not statistically significant between groups.

Conclusions:

• Preliminary findings indicate higher mean maximum stress and strain in ruptured plaques.
• Suggests mechanical forces contribute to coronary plaque rupture.
• Larger studies are needed for further validation due to small sample size.