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• W2955764208 abstract "Atherosclerotic plaque rupture is the common pathological condition of the acute ischemic syndromes of sudden cardiac death and acute myocardial infarction. The rupture of the fibrous cap of a coronary plaque may result in a thrombus formation that would prevent the perfusion of blood downstream of the myocardium. A probable cause of plaque rupture is the mechanical stress induced by the artery wall stretching from the physiological flow of blood and the intraluminal pressure within the coronary arteries. We used computational fluid-structure interaction methods to analyze the effects of coronary blood flow on stenotic atherosclerotic plaques to determine the mechanical stresses within the plaque’s components. We analyzed the effect of the fibrous cap thickness, necrotic core stiffness, and percentage of area stenosis on the mechanical stresses within using comparable models of stenosed arteries. We then analyzed the effect of transient hemodynamic flow using realistic patient-specific geometries under normal coronary flow and pressure. The transient results were used to calculate the amplitude and mean stress for fatigue analyses. Based on this approach, we developed several hypotheses: mechanical fatigue in the fibrous cap is the ultimate characteristic that triggers the rupture; fibrous cap mechanical fatigue (FCMF) can be the result of the combined effects of the cap thickness, relative inclusion stiffness and percentage of stenosis; FCMF can be influenced by the global structure of the obstructive pathology in particular in the context of multiple stenoses, we also show that the anisotropic properties of the collagen fibers within the cap can influence the rupture mechanism. Our results indicate that the combination of a thin fibrous cap, a soft lipid core and a large percentage of stenosis contribute to high mechanical stress magnitudes. Such stresses in mild stenoses can have similar critical behaviors to those normally associated with higher percentage%%%%La rupture de plaques atherosclerotiques est la condition pathologique la plus frequente impliquee dans le syndrome ischemique aigu pouvant mener a l’infarctus du myocarde et a la mort du a l’arret cardiaque. La rupture du cap fibreux de la plaque coronarienne peut resulter dans la formation d’un thrombus qui peut eventuellement empecher la perfusion sanguine en aval du lit myocardique. Une cause possible de la rupture de la plaque est l’etablissement de contraintes mecanique induites par la deformation de la paroi arterielle sous l’ecoulement sanguin et la pression intraluminale a l’interieur des arteres coronaires. Nous avons utilise des methodes de simulation par interaction fluide-structure pour analyser les effets de l’ecoulement coronarien sur les plaques atherosclerotiques pour determiner les contraintes mecaniques sur les constituants de la plaque. Nous avons analyse l’effet de l’epaisseur du cap fibreux, la rigidite de l’inclusion necrotique et le pourcentage en surface de la stenose sur les contraintes mecaniques en utilisant des modeles…" @default.
• W2955764208 created "2019-07-12" @default.
• W2955764208 creator A5031939056 @default.
• W2955764208 date "2009-01-01" @default.
• W2955764208 modified "2023-09-24" @default.
• W2955764208 title "A computational study to assess the effect of the coronary hemodynamics on the mechanical stresses of stenotic atherosclerotic plaques" @default.
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