Correlations between carotid plaque progression and mechanical stresses change sign over time: a patient follow up study using MRI and 3D FSI modelsReportar como inadecuado

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BioMedical Engineering OnLine

, 12:105

First Online: 14 October 2013Received: 18 August 2013Accepted: 24 September 2013


BackgroundIncreasing evidence suggests that mechanisms governing advanced plaque progression may be different from those for early progression and require further investigation. Serial MRI data and 3D fluid–structure interaction FSI models were employed to identify possible correlations between mechanical stresses and advanced plaque progression measured by vessel wall thickness increase WTI. Long-term patient follow up was used to gather data and investigate if the correlations identified above were reproducible.

MethodsIn vivo MRI data were acquired from 16 patients in a follow-up study with 2 to 4 scans for each patient scan interval: average 18 months and standard deviation 6.8 months. A total of 38 scan pairs baseline and follow-up were formed for analysis using the carotid bifurcation as the registration point. 3D FSI models were constructed to obtain plaque wall stress PWS and flow shear stress FSS to quantify their correlations with plaque progression. The Linear Mixed-Effects models were used to study possible correlations between WTI and baseline PWS and FSS with nodal dependence taken into consideration.

ResultsOf the 38 scan pairs, 22 pairs showed positive correlation between baseline PWS and WTI, 1 pair showed negative correlation, and 15 pairs showed no correlation. Thirteen patients changed their correlation sign 81.25%. Between baseline FSS and WTI, 16 pairs showed negative correlation, 1 pair showed positive correlation. Twelve patients changed correlation sign 75%.

ConclusionOur results showed that advanced plaque progression had an overall positive correlation with plaque wall stress and a negative correlation with flow shear stress at baseline. However, long-term follow up showed that correlations between plaque progress and mechanical stresses FSS and PWS identified for one time period were not re-producible for most cases >80%. Further investigations are needed to identify the reasons causing the correlation sign changes.

KeywordsPlaque progression Flow shear stress Atherosclerosis Carotid Fluid–structure interaction Electronic supplementary materialThe online version of this article doi:10.1186-1475-925X-12-105 contains supplementary material, which is available to authorized users.

An erratum to this article is available at

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Autor: Dalin Tang - Chun Yang - Gador Canton - Zheyang Wu - Thomas Hatsukami - Chun Yuan


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