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Influence of microcalcifications on vulnerable plaque mechanics using FSI modeling

Bluestein, Danny and Alemu, Yared and Avrahami, Idit and Gharib, Morteza and Dumont, Kris and Ricotta, John J. and Einav, Shmuel (2008) Influence of microcalcifications on vulnerable plaque mechanics using FSI modeling. Journal of Biomechanics, 41 (5). pp. 1111-1118. ISSN 0021-9290. doi:10.1016/j.jbiomech.2007.11.029.

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Sudden heart attacks remain one of the primary causes of premature death in the developed world. Asymptomatic vulnerable plaques that rupture are believed to prompt such fatal heart attacks and strokes. The role of microcalcifications in the vulnerable plaque rupture mechanics is still debated. Recent studies suggest the microcalcifications increase the plaque vulnerability. In this manuscript we present a numerical study of the role of microcalcifications in plaque vulnerability in an eccentric stenosis model using a transient fluid–structure interaction (FSI) analysis. Two cases are being compared (i) in the absence of a microcalcification (ii) with a microcalcification spot fully embedded in the fibrous cap. Critical plaque stress/strain conditions were affected considerably by the presence of a calcified spot, and were dependent on the timing (phase) during the flow cycle. The vulnerable plaque with the embedded calcification spot presented higher wall stress concentration region in the fibrous cap a bit upstream to the calcified spot, with stress propagating to the deformable parts of the structure around the calcified spot. Following previous studies, this finding supports the hypothesis that microcalcifications increase the plaque vulnerability. Further studies in which the effect of additional microcalcifications and parametric studies of critical plaque cap thickness based on plaque properties and thickness, will help to establish the mechanism by which microcalcifications weaken the plaque and may lead to its rupture.

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Additional Information:© 2007 Elsevier Ltd. Accepted 25 November 2007. This work was performed during the term of an Established Investigator Award from the American Heart Association (DB) under Grant 0340143N from the National American Heart Association, and by the National Science Foundation under Grant no. 0302275 (DB). SE thanks the Drown Foundation for its support. Conflict of interest statement: None of the authors of this paper have any financial and personal relationships with other people or organizations that could inappropriately influence (bias) the presented work.
Funding AgencyGrant Number
American Heart Association Established Investigator AwardUNSPECIFIED
National American Heart Association0340143N
Drown FoundationUNSPECIFIED
Subject Keywords:vulnerable plaque; atherosclerosis; fibrous cap; rupture; microcalcification; numerical modeling; FSI
Issue or Number:5
Record Number:CaltechAUTHORS:20130910-145818894
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Official Citation:Danny Bluestein, Yared Alemu, Idit Avrahami, Morteza Gharib, Kris Dumont, John J. Ricotta, Shmuel Einav, Influence of microcalcifications on vulnerable plaque mechanics using FSI modeling, Journal of Biomechanics, Volume 41, Issue 5, 2008, Pages 1111-1118, ISSN 0021-9290, (
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:41218
Deposited By: Tony Diaz
Deposited On:11 Sep 2013 21:43
Last Modified:10 Nov 2021 04:27

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