Wu Xinlei, von Birgelen Clemens, Li Zehang, Zhang Su, Huang Jiayue, Liang Fuyou, Li Yingguang, Wijns William, Tu Shengxian
Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Shanghai Med-X Engineering Research Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Int J Cardiovasc Imaging. 2018 Jun;34(6):849-861. doi: 10.1007/s10554-018-1311-7. Epub 2018 Feb 3.
Cyclic biomechanical stress at the lumen-intima interface plays a crucial role in the rupture of coronary plaque. We performed a comprehensive assessment of a novel angiography-based method for four-dimensional (4D) dynamic assessment of superficial wall stress (SWS) and deformation with a total of 32 analyses in virtual stenosis models with equal lumen dimensions and 16 analyses in human coronary arteries in vivo. The in silico model analyses demonstrated that the SWS, derived by the proposed global displacement method without knowledge of plaque components or blood pressure, was comparable with the result calculated by traditional finite element method. Cardiac contraction-induced vessel deformation increased SWS. Softer plaque and positive arterial remodeling, associated with a greater plaque burden, showed more variation in mean lumen diameter within the cardiac cycle and resulted in higher SWS. In vivo patient analyses confirmed the accuracy of computed superficial wall deformation. The centerlines predicted by our method at random selected time instant matched well with the actual one in angiograms by Procrustes analysis (scaling: 0.995 ± 0.018; dissimilarity: 0.007 ± 0.014). Over 50% of the maximum SWS occurred at proximal plaque shoulders. This novel 4D approach could be successfully to predict superficial wall deformation of coronary artery in vivo. The dynamic SWS might be more realistic to evaluate the risk of plaque rupture.
管腔-内膜界面处的周期性生物力学应力在冠状动脉斑块破裂中起关键作用。我们对一种基于血管造影的新方法进行了全面评估，该方法用于对浅表壁应力（SWS）和变形进行四维（4D）动态评估，在具有相同管腔尺寸的虚拟狭窄模型中进行了总共32次分析，并在人体冠状动脉体内进行了16次分析。计算机模拟模型分析表明，通过所提出的全局位移方法得出的SWS（无需了解斑块成分或血压）与传统有限元方法计算的结果相当。心脏收缩引起的血管变形增加了SWS。较软的斑块和正向动脉重塑与更大的斑块负荷相关，在心动周期内平均管腔直径显示出更多变化，并导致更高的SWS。体内患者分析证实了计算得出的浅表壁变形的准确性。我们的方法在随机选择的时间点预测的中心线通过Procrustes分析与血管造影中的实际中心线匹配良好（缩放比例：0.995±0.018；差异：0.007±0.014）。超过50%的最大SWS发生在近端斑块肩部。这种新的4D方法可以成功地预测体内冠状动脉的浅表壁变形。动态SWS可能更真实地评估斑块破裂风险。
