Biomechanics of atherosclerotic coronary plaque: Site, stability and in vivo elasticity modeling

Jacques Ohayon, Gerard Finet, Simon Le Floc'h, Guy Cloutier, Ahmed M. Gharib, Julie Heroux, Roderic I. Pettigrew

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Coronary atheroma develop in local sites that are widely variable among patients and are considerably variable in their vulnerability for rupture. This article summarizes studies conducted by our collaborative laboratories on predictive biomechanical modeling of coronary plaques. It aims to give insights into the role of biomechanics in the development and localization of atherosclerosis, the morphologic features that determine vulnerable plaque stability, and emerging in vivo imaging techniques that may detect and characterize vulnerable plaque. Composite biomechanical and hemodynamic factors that influence the actual site of development of plaques have been studied. Plaque vulnerability, in vivo, is more challenging to assess. Important steps have been made in defining the biomechanical factors that are predictive of plaque rupture and the likelihood of this occurring if characteristic features are known. A critical key in defining plaque vulnerability is the accurate quantification of both the morphology and the mechanical properties of the diseased arteries. Recently, an early IVUS based palpography technique developed to assess local strain, elasticity and mechanical instabilities has been successfully revisited and improved to account for complex plaque geometries. This is based on an initial best estimation of the plaque components' contours, allowing subsequent iteration for elastic modulus assessment as a basis for plaque stability determination. The improved method has also been preliminarily evaluated in patients with successful histologic correlation. Further clinical evaluation and refinement are on the horizon.

Original languageEnglish (US)
Pages (from-to)269-279
Number of pages11
JournalAnnals of Biomedical Engineering
Volume42
Issue number2
DOIs
StatePublished - Feb 2014

Keywords

  • Arterial remodeling
  • Atherosclerotic plaque
  • Biomechanics wall stress and elastic modulus
  • Coronary artery disease
  • Modeling
  • Young's modulus

ASJC Scopus subject areas

  • Biomedical Engineering

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