Lee Wookjin, Choi Gyu Jin, Cho Seong Wook
School of Mechanical Engineering, Chung-Ang University, Seoul, South Korea.
Med Biol Eng Comput. 2017 Aug;55(8):1379-1387. doi: 10.1007/s11517-016-1602-x. Epub 2016 Dec 9.
Atherosclerosis is one of the leading causes of death in the world. In this study, an idealized 2D plaque model based on plaque classification in the coronary artery is developed. When creating the idealized 2D model for each plaque type (fibrocalcic, FC; fibrofatty, FT; calcified fibroatheroma, CaFA; fibroatheroma, FA; calcified thin-cap fibroatheroma, CaTCFA; thin-cap fibroatheroma, TCFA), the cap thickness and stenosis by diameter were set as variables. In order to establish the correlation between each plaque type and plaque rupture, a numerical simulation was performed and the stress and stress gradient were reviewed to analyze the mechanical behavior. Results show that both the TCFA and CaTCFA plaque types, which have the smallest cap thicknesses of the different types of plaque, showed relatively high stress values in the thin membrane when compared with the FT type. The FT type is considered to be relatively stable since it does not have necrotic core or a thin membrane. With a stenosis rate of 50% and a cap thickness of 60 μm, the TCFA and CaTCFA types showed approximately 11 and 110% higher stress values, respectively, and 679 and 1568% higher negative stress gradient values, respectively. In other words, the plaque types with thin caps, which have weak load-bearing capacities, showed high stress values and high negative stress gradients in the radial direction. It is understood that this result could indicate the possibility of plaque rupture.
动脉粥样硬化是全球主要死因之一。在本研究中,基于冠状动脉斑块分类构建了理想化的二维斑块模型。在为每种斑块类型(纤维钙化型,FC;纤维脂肪型,FT;钙化纤维粥样瘤,CaFA;纤维粥样瘤,FA;钙化薄帽纤维粥样瘤,CaTCFA;薄帽纤维粥样瘤,TCFA)创建理想化二维模型时,将帽厚度和直径狭窄率设为变量。为了建立每种斑块类型与斑块破裂之间的相关性,进行了数值模拟,并审查应力和应力梯度以分析力学行为。结果表明,与FT型相比,TCFA和CaTCFA这两种在不同类型斑块中帽厚度最小的斑块类型,在薄帽中显示出相对较高的应力值。FT型被认为相对稳定,因为它没有坏死核心或薄帽。在狭窄率为50%且帽厚度为60μm时,TCFA和CaTCFA类型分别显示出约高11%和110%的应力值,以及分别高679%和1568%的负应力梯度值。换句话说,帽薄且承载能力弱的斑块类型在径向方向上显示出高应力值和高负应力梯度。据了解,这一结果可能表明斑块破裂的可能性。