Sameshima Naoki, Yamashita Atsushi, Sato Shinya, Matsuda Shuntaro, Matsuura Yunosuke, Asada Yujiro
Department of Pathology, Faculty of Medicine, University of Miyazaki.
J Atheroscler Thromb. 2014;21(8):831-8. doi: 10.5551/jat.23093. Epub 2014 Mar 25.
To clarify the contribution of hemodynamic factors to the onset of plaque erosion in smooth muscle cell (SMC)-rich atherosclerotic plaque.
We developed a rabbit model of SMC-rich atherosclerotic plaque with various degree of stenosis induced by incomplete ligation and generated three-dimensional models of five rabbit femoral arteries based on 130-162 serial histological cross-sections at 100-μm intervals per artery. We performed a computational blood flow simulation using the Reynolds-averaged Navier-Stokes model and calculated the wall shear stress (WSS), turbulence kinetic energy (TKE), blood pressure (BP) and blood pressure gradients (BPG) in eight sections (the inlet, the stenotic portion and areas 1, 2 and 5mm from the stenotic portion) in each rabbit. We also investigated whether the magnitude of WSS or TKE was related to the presence or absence of erosive injury by evaluating six points (the locally highest, median and lowest of WSS or TKE) in each section.
The magnitudes of WSS, TKE and BPG, but not BP, correlated significantly with the extent of histologically-defined plaque erosion (WSS, r=0.55, p＜0.001; TKE, r=0.53, p＜0.001; BPG, r=0.61, p＜0.0001, n=40). The values for WSS and TKE were significantly larger at sites with, compared to without, erosive injury (n=107 and n=119 points, respectively; both p＜0.0001).
These results suggest that increased values of WSS, TKE and BPG considerably contribute to the onset of plaque erosion.
阐明血流动力学因素对富含平滑肌细胞（SMC）的动脉粥样硬化斑块中斑块侵蚀发生的作用。
我们建立了一个通过不完全结扎诱导不同程度狭窄的富含SMC的动脉粥样硬化斑块兔模型，并基于每条动脉每隔100μm的130 - 162个连续组织学横截面生成了5只兔股动脉的三维模型。我们使用雷诺平均纳维 - 斯托克斯模型进行了计算血流模拟，并计算了每只兔八个截面（入口、狭窄部分以及距狭窄部分1、2和5mm处的区域）的壁面切应力（WSS）、湍流动能（TKE）、血压（BP）和血压梯度（BPG）。我们还通过评估每个截面中的六个点（WSS或TKE的局部最高、中位数和最低值）来研究WSS或TKE的大小是否与糜烂性损伤的存在与否相关。
WSS、TKE和BPG的大小与组织学定义的斑块侵蚀程度显著相关，但BP不相关（WSS，r = 0.55，p＜0.001；TKE，r = 0.53，p＜0.001；BPG，r = 0.61，p＜0.0001，n = 40）。与无糜烂性损伤的部位相比，有糜烂性损伤部位的WSS和TKE值显著更大（分别为n = 107和n = 119个点；均p＜0.0001）。
这些结果表明，WSS、TKE和BPG值的增加对斑块侵蚀的发生有很大作用。
