Plaque Growth Functions Combining Wall Stress, Flow Shear Stress and Morphology May Provide Better Prediction for Atherosclerosis Progression: 3D FSI Studies Based on In Vivo Serial MRI

Author(s):  
Chun Yang ◽  
Gador Canton ◽  
Chun Yuan ◽  
Tom Hatsukami ◽  
Dalin Tang

Atherosclerotic plaque progression involves biological, structural and mechanical factors. Previous work has shown that initiation and early progression of atherosclerotic plaque correlate negatively with flow wall shear stresses [1–2]. However, plaque growth functions based on patient-specific data to predict future plaque growth are lacking in the current literature. Six plaque growth functions based on fluid-structure-interaction (FSI) models and in vivo serial magnetic resonance image (MRI) data were proposed for progression prediction. This is to test the hypothesis that combining plaque morphology, plaque wall maximum principal stress (WS), strain (WSN) and flow maximum shear stress (FSS) could better predict plaque progression.

Author(s):  
Chun Yang ◽  
Joseph D. Petruccelli ◽  
Zhongzhao Teng ◽  
Chun Yuan ◽  
Gador Canton ◽  
...  

Atherosclerotic plaque rupture and progression have been the focus of intensive investigations in recent years. The mechanisms governing plaque progression and rupture process are not well understood. Using computational models based on patient-specific multi-year in vivo MRI data, our recent results indicated that 18 out of 21 patients studied showed significant negative correlation between plaque progression measured by vessel wall thickness increase (WTI) and plaque wall (structural) stress (PWS) [1]. In this paper, a computational procedure based on meshless generalized finite difference (MGFD) method and serial magnetic resonance imaging (MRI) data was introduced to simulate plaque progression. Participating patients were scanned three times (T1, T2, and T3, at intervals of approximately 18 months) to obtain plaque progression data. Vessel wall thickness (WT) changes were used as the measure for plaque progression. Starting from T2 plaque geometry, plaque progression was simulated by solving the solid model and adjusting wall thickness using plaque growth functions iteratively until time T3 is reached. Numerically simulated plaque progression showed very good agreement with actual plaque geometry at T3 given by MRI data. We believe this is the first time plaque progression simulation results based on multi-year patient-tracking data are reported. Multi-year tracking data and MRI-based progression simulation add time dimension to plaque vulnerability assessment and will improve prediction accuracy.


Author(s):  
Chun Yang ◽  
Gador Canton ◽  
Chun Yuan ◽  
Thomas Hatsukami ◽  
Dalin Tang

It has been well accepted that low and oscillating blood flow shear stresses (LFSS) correlate positively with intimal thickening and atherosclerosis initiation [1,2]. However, the LFSS hypothesis cannot explain why advanced plaques continue to grow under elevated high flow shear stress conditions [3]. For patient tracking studies, plaque progression is often measured by the difference of plaque geometries between two scans (“past” and “current” scans) when medical imaging is used. Mechanical flow shear stress (FSS) and plaque wall stress (PWS) conditions from the two scans may have different correlations with plaque progression. Using 2D structure models based on in vivo magnetic resonance imaging (MRI) human carotid plaques, Tang et al. showed that 18 out of 21 patients had significant negative correlation between plaque progression measured by wall thickness increase (WTI) and plaque wall stress from current scan [3]. The correlation was reversed when plaque wall stress from past scan was used. In this paper, 3D fluid-structure interactions (FSI) models for 32 matched “past-current” scan pairs of human atherosclerotic carotid plaques based on in vivo MRI data were solved and plaque wall stress (PWS) and flow shear stress (FSS) data were obtained to quantify their correlations with plaque progression measured by WTI.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E M J Hartman ◽  
A M Kok ◽  
A Hoogendoorn ◽  
F J H Gijsen ◽  
A F W Steen ◽  
...  

Abstract Introduction Local wall shear stress (WSS) metrics, high local lipid levels (as detected by near-infrared spectroscopy (NIRS)), as well as systemic lipid levels, have been individually associated with atherosclerotic disease progression. However, a possible synergistic effect remains to be elucidated. This study is the first study to combine WSS metrics with NIRS-detected local lipid content to investigate a potential synergistic effect on plaque progression in human coronary arteries. Methods The IMPACT study is a prospective, single centre study investigating the relation between atherosclerotic plaque progression and WSS in human coronary arteries. Patients with ACS treated with PCI were included. At baseline and after 1-year follow-up, patients underwent near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) imaging and intravascular doppler flow measurements of at least one non-culprit coronary artery. After one month, a CT angiography was made. CT derived centreline combined with IVUS lumen contours resulted in a 3D reconstruction of the vessel. The following WSS metrics were computed using computational fluid dynamics applying the vessel specific invasive flow measurements: time-average wall shear stress (TAWSS), relative residence time (RRT), cross-flow index, oscillatory shear index and transverse wall shear stress. Low TAWSS is known as pro atherogenic, in contrast to all the other shear stress metrics, at which a high magnitude is pro-atherogenic. The arteries were divided into 1.5mm/45° sectors. Based on NIRS-IVUS, wall thickness change over time was determined and NIRS positive sectors detected. Furthermore, per vessel the shear stress was divided into tertiles (low, intermediate, high). To investigate the synergistic effect of local lipids on shear stress related plaque growth, wall thickness change over time was related to the different shear stress metrics comparing the NIRS-positive with the NIRS-negative sectors. Results 15 non-culprit coronary arteries from the first 14 patients were analyzed (age 62±10 years old and 92.9% male). A total of 2219 sectors were studied (5.2%, N=130, NIRS-positive) for wall thickness changes. After studying all five shear stress metrics, we found for TAWSS and RRT that presence of lipids, as detected by NIRS, amplified the effect of shear stress on plaque progression (see figure). Sectors presenting with lipid-rich plaque, compared to NIRS-negative sectors, showed more progression when they were exposed to low TAWSS (p=0.07) or high RRT (p=0.012) and more regression in sectors exposed to high TAWSS (p=0.10) or low RRT (p=0.06). Delta wall thickness vs shear stress Conclusion We presented the first preliminary results of the IMPACT study, showing the synergistic effect of lipid rich plaque and shear stress on plaque progression. Therefore, intravascular lipid-rich plaque (NIRS) assessment has added value to shear stress profiling for the prediction of plaque growth, leading to improved risk stratification. Acknowledgement/Funding ERC starting grant 310457


2018 ◽  
Vol 5 (3) ◽  
pp. 171447 ◽  
Author(s):  
R. Xing ◽  
A. M. Moerman ◽  
Y. Ridwan ◽  
M. J. Daemen ◽  
A. F. W. van der Steen ◽  
...  

Wall shear stress (WSS) is involved in atherosclerotic plaque initiation, yet its role in plaque progression remains unclear. We aimed to study (i) the temporal and spatial changes in WSS over a growing plaque and (ii) the correlation between WSS and plaque composition, using animal-specific data in an atherosclerotic mouse model. Tapered casts were placed around the right common carotid arteries (RCCA) of ApoE −/− mice. At 5, 7 and 9 weeks after cast placement, RCCA geometry was reconstructed using contrast-enhanced micro-CT. Lumen narrowing was observed in all mice, indicating the progression of a lumen intruding plaque. Next, we determined the flow rate in the RCCA of each mouse using Doppler Ultrasound and computed WSS at all time points. Over time, as the plaque developed and further intruded into the lumen, absolute WSS significantly decreased. Finally at week 9, plaque composition was histologically characterized. The proximal part of the plaque was small and eccentric, exposed to relatively lower WSS. Close to the cast a larger and concentric plaque was present, exposed to relatively higher WSS. Lower WSS was significantly correlated to the accumulation of macrophages in the eccentric plaque. When pooling data of all animals, correlation between WSS and plaque composition was weak and no longer statistically significant. In conclusion, our data showed that in our mouse model absolute WSS strikingly decreased during disease progression, which was significantly correlated to plaque area and macrophage content. Besides, our study demonstrates the necessity to analyse individual animals and plaques when studying correlations between WSS and plaque composition.


2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Qingyu Wang ◽  
Dalin Tang ◽  
Gador Canton ◽  
Jian Guo ◽  
Xiaoya Guo ◽  
...  

It is hypothesized that artery stiffness may be associated with plaque progression. However, in vivo vessel material stiffness follow-up data is lacking in the literature. In vivo 3D multi-contrast and Cine magnetic resonance imaging (MRI) carotid plaque data were acquired from 8 patients with follow-up (18 months) with written informed consent obtained. Cine MRI and 3D thin-layer models were used to determine parameter values of the Mooney-Rivlin models for the 81slices from 16 plaques (2 scans/patient) using our established iterative procedures. Effective Young’s Modulus (YM) values for stretch ratio [1.0,1.3] were calculated for each slice for analysis. Stress-stretch ratio curves from Mooney-Rivlin models for the 16 plaques and 81 slices are given in Fig. 1. Average YM value of the 81 slices was 411kPa. Slice YM values varied from 70 kPa (softest) to 1284 kPa (stiffest), a 1734% difference. Average slice YM values by vessel varied from 109 kPa (softest) to 922 kPa (stiffest), a 746% difference. Location-wise, the maximum slice YM variation rate within a vessel was 306% (139 kPa vs. 564 kPa). Average slice YM variation rate within a vessel for the 16 vessels was 134%. Average variation of YM values from baseline (T1) to follow up (T2) for all patients was 61.0%. The range of the variation of YM values was [-28.4%, 215%]. For progression study, YM increase (YMI=YM T2 -TM T1 ) showed negative correlation with plaque progression measured by wall thickness increase (WTI), (r= -0.6802, p=0.0634). YM T2 showed strong negative correlation with WTI (r= -0.7764, p=0.0235). Correlation between YM T1 and WTI was not significant (r= -0.4353, p= 0.2811). Conclusion In vivo carotid vessel material properties have large variations from patient to patient, along the vessel segment within a patient, and from baseline to follow up. Use of patient-specific, location specific and time-specific material properties could potentially improve the accuracy of model stress/strain calculations.


2013 ◽  
Vol 184 (4-5) ◽  
pp. 299-306 ◽  
Author(s):  
Richard J. Lisle

AbstractThe assumption is widely made that slip on faults occurs in the direction of maximum resolved shear stress, an assumption known as the Wallace-Bott hypothesis. This assumption is used to theoretically predict slip directions from known in situ stresses, and also as the basis of palaeostress inversion from fault-slip data. This paper examines different situations in relation to the appropriateness of this assumption. Firstly, it is shown that the magnitude of the shear stress resolved within a plane is a function with a poorly defined maximum direction, so that shear stress values greater than 90% of the maximum occur within a wide angular range (± 26°) degrees. The situation of simultaneous movement on pairs of faults requires slip on each fault to be parallel to their mutual line of intersection. However, the resolved shear stresses arising from a homogeneous state of stress do not accord with such a slip arrangement except in the case of pairs of perpendicular faults. Where fault surfaces are non-planar, the directions of resolved shear stress in general give, according to the Wallace-Bott hypothesis, a set of slip directions of rigid fault blocks, which is generally kinematically incompatible. Finally, a simple model of a corrugated fault suggests that any anisotropy of the shear strength of the fault such as that arising from fault surface topography, can lead to a significant angular difference between the directions of maximum shear stress and the slip direction.These findings have relevance to the design of procedures used to estimate palaeostresses and the amount of data required for this type of analysis.


2018 ◽  
Vol 147 ◽  
pp. 01005
Author(s):  
Jonie Tanijaya

This study is carried out to evaluate the potential of three hybrid T-beams with web openings theoretical shear stresses distribution. The shear stresses at the opening edges were plotted at the working stage, yielding stage and collapse stage for these three tested beams. The available experimental results from the previous research was compared to the finite element results as well as the developed analytical. The shear stress distribution at the middle of the top and bottom chords of the opening in pure bending region are zero. At the upper and lower corners of the opening occurs the maximum shear stresses. The maximum shear stress occurs at the right lower corner chord at the high moment edge and at the left upper corner chord at the low moment edge in beams with openings at high shear and high flexural – shear region. Furthermore, an extensive parametric study is performed on these beams to find the distributing ratio of the shear force between the opening chords. The shear force at an opening in hybrid R/C T-beam is carried by the top and bottom chords of the opening according to the area – moment of inertia root ratio with the correction factor 0.70.


2001 ◽  
Vol 281 (2) ◽  
pp. H796-H803 ◽  
Author(s):  
David W. Stepp ◽  
Daphne Merkus ◽  
Yasuhiro Nishikawa ◽  
William M. Chilian

Increases in shear stress promote coronary vasodilation by stimulating the production of nitric oxide (NO). Whether shear stress-induced NO production also limits vasoconstriction in the coronary microcirculation in vivo is unknown. Accordingly, we measured microvascular diameter and flow velocity in the beating heart along with estimated blood viscosity to calculate shear stress during vasoconstriction with endothelin or vasopressin. Measurements were repeated in the presence of N G-monomethyl-l-arginine (l-NMMA) to inhibit NO production and BQ-788 to block NO-linked endothelin type B receptors. BQ-788 did not augment steady-state constriction to endothelin, suggesting that NO production via activation of this receptor is inconsequential. l-NMMA potentiated constriction to both agonists, particularly in small arteries (inner diameter >120 μm). Shear stresses in small arteries were elevated during constriction and further elevated during constriction after l-NMMA. These observations suggest that NO production limits vasoconstriction in the coronary microcirculation and that the principal stimulus for this governance is elevated shear stress. The degree of shear stress moderation of constriction is heterogeneously distributed, with small arteries displaying a higher degree of shear stress regulation than arterioles. These results provide the strongest evidence to date that shear stress-mediated production of NO exerts a “braking” influence on constriction in the coronary microcirculation.


2012 ◽  
Vol 134 (9) ◽  
Author(s):  
Matthew D. Ford ◽  
Ugo Piomelli

Cerebral aneurysms are a common cause of death and disability. Of all the cardiovascular diseases, aneurysms are perhaps the most strongly linked with the local fluid mechanic environment. Aside from early in vivo clinical work that hinted at the possibility of high-frequency intra-aneurysmal velocity oscillations, flow in cerebral aneurysms is most often assumed to be laminar. This work investigates, through the use of numerical simulations, the potential for disturbed flow to exist in the terminal aneurysm of the basilar bifurcation. The nature of the disturbed flow is explored using a series of four idealized basilar tip models, and the results supported by four patient specific terminal basilar tip aneurysms. All four idealized models demonstrated instability in the inflow jet through high frequency fluctuations in the velocity and the pressure at approximately 120 Hz. The instability arises through a breakdown of the inflow jet, which begins to oscillate upon entering the aneurysm. The wall shear stress undergoes similar high-frequency oscillations in both magnitude and direction. The neck and dome regions of the aneurysm present 180 deg changes in the direction of the wall shear stress, due to the formation of small recirculation zones near the shear layer of the jet (at the frequency of the inflow jet oscillation) and the oscillation of the impingement zone on the dome of the aneurysm, respectively. Similar results were observed in the patient-specific models, which showed high frequency fluctuations at approximately 112 Hz in two of the four models and oscillations in the magnitude and direction of the wall shear stress. These results demonstrate that there is potential for disturbed laminar unsteady flow in the terminal aneurysm of the basilar bifurcation. The instabilities appear similar to the first instability mode of a free round jet.


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