Calcifications in atherosclerotic plaques and impact on plaque biomechanics

JOURNAL OF BIOMECHANICS

卷:87

Review

Barrett, Hilary E.¹  Van der Heiden, Kim¹  Farrell, Eric²  Gijsen, Frank J. H.¹  Akyildiz, Ali C.¹ 

[1] Erasmus MC, Thoraxctr, Dept Biomed Engn, Ee2341,POB 2040, NL-3000 CA Rotterdam, Netherlands

[2] Erasmus MC, Dept Oral & Maxillofacial Surg, Rotterdam, Netherlands

关键词: Plaque rupture;    Microcalcification;    Macrocalcification;    Mechanical properties;   

DOI  :  10.1016/j.jbiomech.2019.03.005

来源: Elsevier

【 摘 要 】

The catastrophic mechanical rupture of an atherosclerotic plaque is the underlying cause of the majority of cardiovascular events. The infestation of vascular calcification in the plaques creates a mechanically complex tissue composite. Local stress concentrations and plaque tissue strength properties are the governing parameters required to predict plaque ruptures. Advanced imaging techniques have permitted insight into fundamental mechanisms driving the initiating inflammatory-driven vascular calcification of the diseased intima at the (sub-) micron scale and up to the macroscale. Clinical studies have potentiated the biomechanical relevance of calcification through the derivation of links between local plaque rupture and specific macrocalcification geometrical features. The clinical implications of the data presented in this review indicate that the combination of imaging, experimental testing, and computational modelling efforts are crucial to predict the rupture risk for atherosclerotic plaques. Specialised experimental tests and modelling efforts have further enhanced the knowledge base for calcified plaque tissue mechanical properties. However, capturing the temporal instability and rupture causality in the plaque fibrous caps remains elusive. Is it necessary to move our experimental efforts down in scale towards the fundamental (sub-) micron scales in order to interpret the true mechanical behaviour of calcified plaque tissue interactions that is presented on a macroscale in the clinic and to further optimally assess calcified plaques in the context of biomechanical modelling. (C) 2019 The Author(s). Published by Elsevier Ltd.

【 授权许可】

Free