Strain Distribution Over Plaques in Human Coronary Arteries Relates to Shear Stress

It is well established that atherosclerotic plaques generally develop in low shear stress regions, including curved arterial segments and bifurcations. Once these plaques intrude into the lumen, the shear stress they are exposed to alters with hitherto unknown consequences. We hypothesize that in the more advanced stages of the disease, shear stress has an important impact on plaque composition in such a way that high shear stress enhances plaque vulnerability through its biological impact on the endothelium. We investigated this hypothesis by studying the relationship between shear stress and strain, a marker for plaque composition, in human coronary arteries.

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Shear Stress Modulates Plaque Composition in Human Coronary Arteries In Vivo

ASME 2008 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2008-192764 ◽

2008 ◽

Author(s):

Frank Gijsen ◽

Jolanda Wentzel ◽

Johan Schuurbiers ◽

Frits Mastik ◽

Johannes Schaar ◽

...

Keyword(s):

Shear Stress ◽

Atherosclerotic Plaques ◽

Plaque Composition ◽

Low Shear Stress ◽

Advanced Stages ◽

Shear Stress And Strain ◽

Stress Influences ◽

The Relationship ◽

Low Shear

It is well established that atherosclerotic plaques generally develop in low shear stress regions, including curved arterial segments and bifurcations1. Once these plaques intrude into the lumen, the shear stress they are exposed to alters with hitherto unknown consequences. We hypothesize that in the more advanced stages of the disease, shear stress has an important impact on plaque composition in such a way that high shear stress enhances plaque vulnerability through its biological impact on the endothelium2. We investigated this hypothesis previously by studying the relationship between shear stress and strain, a marker for plaque composition, in human coronary arteries3. In this study, we will extend that study by investigating how shear stress influences changes of strain, and thus plaque composition, over a period of 6 months.

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Plaque and Shear Stress Distribution in Human Coronary Bifurcations: a Multi-Slice Computed Tomography Study

ASME 2007 Summer Bioengineering Conference ◽

10.1115/sbc2007-176309 ◽

2007 ◽

Cited By ~ 1

Author(s):

Alina G. van der Giessen ◽

Jolanda J. Wentzel ◽

Frans N. van de Vosse ◽

Antonius F. van der Steen ◽

Pim J. de Feyter ◽

...

Keyword(s):

Computed Tomography ◽

Shear Stress ◽

Outer Wall ◽

Atherosclerotic Plaques ◽

Advanced Stage ◽

Flow Divider ◽

Low Shear Stress ◽

Curved Vessels ◽

Early Atherosclerosis ◽

Low Shear

It is generally accepted that early atherosclerosis develops in low shear-stress (SS) regions such as the outer wall of arterial bifurcations and the inner bend of curved vessels (1). However, in clinical practice, it is common to observe atherosclerotic plaques at the flow-divider, or carina, of coronary bifurcations (2). Plaques at the carina are more frequently found in symptomatic patients, and may represent a more advanced stage of atherosclerosis. The carina is located in a region which is exposed to high SS. We hypothesize that if plaques are located in atheroprotective high SS regions, they have grown circumferentially from the atherogenic low SS regions.

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Arginase inhibition prevents the low shear stress-induced development of vulnerable atherosclerotic plaques in ApoE−/− mice

Atherosclerosis ◽

10.1016/j.atherosclerosis.2012.12.014 ◽

2013 ◽

Vol 227 (2) ◽

pp. 236-243 ◽

Cited By ~ 25

Author(s):

Vania C. Olivon ◽

Rodrigo A. Fraga-Silva ◽

Dolf Segers ◽

Céline Demougeot ◽

Ana M. de Oliveira ◽

...

Keyword(s):

Shear Stress ◽

Atherosclerotic Plaques ◽

Low Shear Stress ◽

Low Shear

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Numerical Simulation of Blood Flow in the Renal Arteries: Influence of the Ostium Flow Diverter

Volume 1B: Extremity; Fluid Mechanics; Gait; Growth, Remodeling, and Repair; Heart Valves; Injury Biomechanics; Mechanotransduction and Sub-Cellular Biophysics; MultiScale Biotransport; Muscle, Tendon and Ligament; Musculoskeletal Devices; Multiscale Mechanics; Thermal Medicine; Ocular Biomechanics; Pediatric Hemodynamics; Pericellular Phenomena; Tissue Mechanics; Biotransport Design and Devices; Spine; Stent Device Hemodynamics; Vascular Solid Mechanics; Student Paper and Design Competitions ◽

10.1115/sbc2013-14250 ◽

2013 ◽

Author(s):

Scott Albert ◽

Jenn Stroud Rossmann ◽

Robert Balaban

Keyword(s):

Shear Stress ◽

Vessel Wall ◽

Flow Diverter ◽

Atherosclerotic Plaques ◽

Residence Times ◽

Branch Points ◽

Tissue Microenvironment ◽

Low Shear Stress ◽

Arterial Branch ◽

Low Shear

The tendency of atherosclerotic plaques to develop at arterial branch points is likely due to both the hemodynamics and macromolecular environment associated with these branch points. Arterial branches experience flow separation, which results in regions of low shear stress[1–3], and contributes to longer residence times that may allow for deposition of pro-atherogenic material in the vessel wall [2]. In addition, low shear stress itself may provide cellular signals that alter the tissue microenvironment in favor of atherogenesis [3, e.g.].

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Strain distribution over plaques in human coronary arteries relates to shear stress

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01081.2007 ◽

2008 ◽

Vol 295 (4) ◽

pp. H1608-H1614 ◽

Cited By ~ 125

Author(s):

Frank J. H. Gijsen ◽

Jolanda J. Wentzel ◽

Attila Thury ◽

Frits Mastik ◽

Johannes A. Schaar ◽

...

Keyword(s):

Shear Stress ◽

Coronary Arteries ◽

Plaque Rupture ◽

Stress And Strain ◽

Shear Stresses ◽

High Shear ◽

High Shear Stress ◽

Plaque Composition ◽

Downstream Region ◽

Shear Stress And Strain

Once plaques intrude into the lumen, the shear stress they are exposed to alters with hitherto unknown consequences for plaque composition. We investigated the relationship between shear stress and strain, a marker for plaque composition, in human coronary arteries. We imaged 31 plaques in coronary arteries with angiography and intravascular ultrasound. Computational fluid dynamics was used to obtain shear stress. Palpography was applied to measure strain. Each plaque was divided into four regions: upstream, throat, shoulder, and downstream. Average shear stress and strain were determined in each region. Shear stress in the upstream, shoulder, throat, and downstream region was 2.55 ± 0.89, 2.07 ± 0.98, 2.32 ± 1.11, and 0.67 ± 0.35 Pa, respectively. Shear stress in the downstream region was significantly lower. Strain in the downstream region was also significantly lower than the values in the other regions (0.23 ± 0.08% vs. 0.48 ± 0.15%, 0.43 ± 0.17%, and 0.47 ± 0.12%, for the upstream, shoulder, and throat regions, respectively). Pooling all regions, dividing shear stress per plaque into tertiles, and computing average strain showed a positive correlation; for low, medium, and high shear stress, strain was 0.23 ± 0.10%, 0.40 ± 0.15%, and 0.60 ± 0.18%, respectively. Low strain colocalizes with low shear stress downstream of plaques. Higher strain can be found in all other plaque regions, with the highest strain found in regions exposed to the highest shear stresses. This indicates that high shear stress might destabilize plaques, which could lead to plaque rupture.

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