Fibrous cap delamination is a critical process during the rupture of atherosclerotic plaque, which often leads to severe life-threatening clinical consequences such as myocardial infarction or stroke. In this study a finite element modeling and simulation approach is presented that enables the study of fibrous cap delamination experiments for the purpose of understanding the fibrous cap delamination process. A cohesive zone model (CZM) approach is applied to simulate delamination of the fibrous cap from the underlying plaque tissue. A viscoelastic anisotropic (VA) model for the bulk arterial material behavior is extended from existing studies so that the hysteresis phenomenon observed in the fibrous cap delamination experiments can be captured. A finite element model is developed for the fibrous cap delamination experiments, in which arterial layers (including the fibrous cap and the underlying plaque tissue) are represented by solid elements based on the VA model and the fibrous cap-underlying plaque tissue interface is characterized by interfacial CZM elements. In the CZM, the delamination process is governed by an exponential traction-separation law which utilizes critical energy release rates obtained directly from the fibrous cap delamination experiments. A set of VA model parameter values and CZM parameter values is determined based on values suggested in the literature and through matching simulation predictions of the load vs. load-point displacement curve with one set of experimental measurements. Using this set of parameter values, simulation predictions for other sets of experimental measurements are obtained and good agreement between simulation predictions and experimental measurements is observed. Results of this study demonstrate the applicability of the viscoelastic anisotropic model and the CZM approach for the simulation of diseased arterial tissue failure processes.
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http://dx.doi.org/10.1016/j.jmbbm.2016.02.011 | DOI Listing |
Atherosclerosis
January 2025
State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Department of Cardiology of the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. Electronic address:
Background And Aims: Histologic studies indicated that healed plaque, characterized by a multilayered pattern, is indicative of prior atherothrombosis and subsequent healing. However, longitudinal in vivo data on healed plaque formation in non-culprit plaques are limited. This study aimed to investigate serial changes and clinical significance of new layered pattern formation in non-culprit plaques in patients with acute coronary syndromes (ACS) using serial optical coherence tomography (OCT) imaging.
View Article and Find Full Text PDFCardiovasc Diagn Ther
December 2024
Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center of Cardiovascular Wisdom Diagnosis and Treatment, Beijing, China.
Background: The prevalence of very high-risk atherosclerotic cardiovascular disease (ASCVD) is significant in China, with suboptimal rates of low-density lipoprotein cholesterol (LDL-C) compliance exacerbating plaque instability and causing a higher incidence of major adverse cardiac events (MACEs). Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are effective in reducing LDL-C levels, increase the stability of vulnerable plaque, and influence the progression of atherosclerosis through multiple mechanisms as demonstrated in animal studies. However, there is currently a lack of evidence regarding the efficacy and safety of high-intensity statin therapy combined with PCSK9i in the secondary prevention of ASCVD in the Chinese population.
View Article and Find Full Text PDFInt J Cardiovasc Imaging
December 2024
Senior Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
Patients with diabetes mellitus (DM) have an increased risk of in stent restenosis (ISR). Neovascularization (NV) is considered as a unique pathophysiology factor of ISR in diabetic patients. However, the restructuring patterns of in vivo human coronary NV and their relationship with ISR, especially in diabetic patients remain unclear.
View Article and Find Full Text PDFJ Biomech Eng
February 2025
Department of Biomedical Engineering and Science, Florida Institute of Technology, 150 West University Boulevard, Melbourne, FL 32901.
Lipid-rich atheromas are linked to plaque rupture in stented atherosclerotic arteries. While fibrous cap thickness is acknowledged as a critical indicator of vulnerability, it is likely that other morphological features also exert influence. However, detailed quantifications of their contributions and intertwined effects in stenting are lacking.
View Article and Find Full Text PDFCurr Atheroscler Rep
December 2024
CVPath Institute, Inc, 19 Firstfield Road, Gaithersburg, MD, 20878, USA.
Purpose Of Review: Plaque erosion is the second leading cause of coronary thrombosis following plaque rupture and represents a key pathophysiological process underlying acute coronary syndromes that can culminate in sudden coronary death. While the precise mechanisms and risk factors driving plaque rupture are well-established, those for erosion have only recently been explored. This review summarizes current literature on the characteristics and risk factors favoring plaque erosion.
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