Sadat Umar, Mercer John R, Bahaei Nasim S, Thomas Owen M, Gillard Jonathan H
IEEE Trans Biomed Eng. 2014 Jan;61(1):35-40. doi: 10.1109/TBME.2013.2275078. Epub 2013 Jul 31.
The impact of calcification on the carotid atherosclerotic plaque vulnerability remains controversial and unclear. This study assesses the critical mechanical conditions induced by the calcium at the lumen surface, i.e., juxtaluminal calcification (JLCa), within human carotid atherosclerotic plaque. Eleven patients with evidence of JLCa were included for the analysis. The plaque geometry was reconstructed based on computed tomography and magnetic resonance images and 3-D fluid-structure interaction simulation was used for mechanical analysis. The presence of JLCa increased local stresses compared to when calcification was artificially covered with a 0.2-mm-thick fibrous cap (107.87 kPa [76.99, 129.14] versus 63.17 kPa [34.55, 75.13]; Median, [interquartile range]; ). Stretch ratio decreased from 1.18 [1.07, 1.27] to 1.13 [1.10, 1.18] (p = 0.03). The presence of JLCa significantly elevates local stress and stretch level. Further exploration of this plaque feature is warranted as a possible risk factor causing plaque vulnerability.
钙化对颈动脉粥样硬化斑块易损性的影响仍存在争议且尚不明确。本研究评估了人类颈动脉粥样硬化斑块内管腔表面钙（即管腔周围钙化，JLCa）所引发的关键力学条件。纳入11例有JLCa证据的患者进行分析。基于计算机断层扫描和磁共振图像重建斑块几何形状，并采用三维流固耦合模拟进行力学分析。与用0.2毫米厚的纤维帽人工覆盖钙化时相比，JLCa的存在增加了局部应力（107.87千帕[76.99，129.14]对63.17千帕[34.55，75.13]；中位数，[四分位间距]；）。拉伸率从1.18[1.07，1.27]降至1.13[1.10，1.18]（p = 0.03）。JLCa的存在显著提高了局部应力和拉伸水平。作为导致斑块易损性的一个可能危险因素，有必要对这一斑块特征进行进一步探究。
