UNASSIGNED: We performed numerical simulations on 3D idealized lesions and a microCT-derived human coronary atheroma, to quantitatively analyze the atheroma cap rupture. From the predicted cap stresses, we defined a biomechanics-based vulnerability index (VI) to classify the impact of each risk factor on plaque stability, and developed a predictive model based on their synergistic effect.
UNASSIGNED: Plaques with low remodeling index and soft lipid cores exhibit higher VI and can shift the location of maximal wall stresses. The VI exponentially rises as the cap becomes thinner, while the presence of a μCalc causes an additional 2.5-fold increase in vulnerability for a spherical inclusion. The human coronary atheroma model had a stable phenotype, but it was transformed into a vulnerable plaque after introducing a single spherical μCalc in its cap. Overall, cap thickness and μCalcs are the two most influential factors of mechanical rupture risk.
UNASSIGNED: Our findings provide supporting evidence that high risk lesions are non-obstructive plaques with softer (lipid-rich) cores and a thin cap with μCalcs. However, stable plaques may still rupture in the presence of μCalcs.
UNASSIGNED:我们对3D理想化病变和microCT衍生的人冠状动脉粥样斑块进行了数值模拟,对动脉粥样硬化帽破裂进行定量分析。根据预测的盖应力,我们定义了一个基于生物力学的易损性指数(VI)来分类每个危险因素对斑块稳定性的影响,并根据其协同效应建立了预测模型。
UNASSIGNED:具有低重塑指数和柔软脂质核心的斑块表现出较高的VI,并且可以改变最大壁应力的位置。随着盖子变薄,VI呈指数上升,而μCalc的存在会导致球形夹杂物的脆弱性增加2.5倍。人冠状动脉粥样硬化模型具有稳定的表型,但是在其帽中引入单个球形μCalc后,它被转化为易损斑块。总的来说,瓶盖厚度和μCalcs是影响机械破裂风险的两个最大因素。
UNASSIGNED:我们的研究结果提供了支持证据,表明高风险病变是非阻塞性斑块,具有较柔软(富含脂质)的核心和带有μCalcs的薄帽。然而,在μCalcs存在下,稳定的斑块仍可能破裂。