Document Detail

Normalized wall index specific and MRI-based stress analysis of atherosclerotic carotid plaques: a study comparing acutely symptomatic and asymptomatic patients.
MedLine Citation:
PMID:  20834184     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Biomechanical stresses play an important role in determining plaque stability. Quantification of these simulated stresses can be potentially used to assess plaque vulnerability and differentiate different patient groups.
METHODS AND RESULTS: 54 asymptomatic and 45 acutely symptomatic patients underwent in vivo multicontrast magnetic resonance imaging (MRI) of the carotid arteries. Plaque geometry used for nite element analysis was derived from in vivo MRI at the sites of maximum and minimum plaque burden. In total, 198 slices were used for the computational simulations. A pre-shrink technique was used to refine the simulation. Maximum principle stress at the vulnerable plaque sites (ie, critical stress) was extracted for the selected slices and a comparison was performed between the 2 groups. Critical stress in the slice with maximum plaque burden is significantly higher in acutely symptomatic patients as compared to asymptomatic patients (median, inter quartile range: 198.0 kPa (119.8-359.0 kPa) vs 138.4 kPa (83.8-242.6 kPa), P=0.04). No significant difference was found in the slice with minimum plaque burden between the 2 groups (196.7 kPa (133.3-282.7 kPa) vs 182.4 kPa (117.2-310.6 kPa), P=0.82).
CONCLUSIONS: Acutely symptomatic carotid plaques have significantly high biomechanical stresses than asymptomatic plaques. This might be potentially useful for establishing a biomechanical risk stratification criteria based on plaque burden in future studies.
Chengcheng Zhu; Zhongzhao Teng; Umar Sadat; Victoria E Young; Martin J Graves; Zhi Yong Li; Jonathan H Gillard
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-08
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-11-30     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2360-4     Citation Subset:  IM    
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MeSH Terms
Asymptomatic Diseases
Biomechanical Phenomena
Brain Ischemia / etiology*,  pathology
Carotid Arteries / pathology*
Carotid Stenosis / complications,  diagnosis*,  pathology
Computer Simulation
Finite Element Analysis
Image Interpretation, Computer-Assisted
Magnetic Resonance Angiography*
Predictive Value of Tests
Risk Assessment
Severity of Illness Index
Stress, Mechanical
Grant Support
G0800480//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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