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Biomechanics of Atherosclerotic Coronary Plaque: Site, Stability and In Vivo Elasticity Modeling

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Abstract

Coronary atheroma develop in local sites that are widely variable among patients and are considerably variable in their vulnerability for rupture. This article summarizes studies conducted by our collaborative laboratories on predictive biomechanical modeling of coronary plaques. It aims to give insights into the role of biomechanics in the development and localization of atherosclerosis, the morphologic features that determine vulnerable plaque stability, and emerging in vivo imaging techniques that may detect and characterize vulnerable plaque. Composite biomechanical and hemodynamic factors that influence the actual site of development of plaques have been studied. Plaque vulnerability, in vivo, is more challenging to assess. Important steps have been made in defining the biomechanical factors that are predictive of plaque rupture and the likelihood of this occurring if characteristic features are known. A critical key in defining plaque vulnerability is the accurate quantification of both the morphology and the mechanical properties of the diseased arteries. Recently, an early IVUS based palpography technique developed to assess local strain, elasticity and mechanical instabilities has been successfully revisited and improved to account for complex plaque geometries. This is based on an initial best estimation of the plaque components’ contours, allowing subsequent iteration for elastic modulus assessment as a basis for plaque stability determination. The improved method has also been preliminarily evaluated in patients with successful histologic correlation. Further clinical evaluation and refinement are on the horizon.

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Acknowledgments

The authors would like to thank Shadi Mamaghani, Ph.D. for her expert assistance in the review and editing of the manuscript. This research was supported in part by an appointment (J. Ohayon) to the Senior Fellow Program at the National Institutes of Health (NIH) 2006–2007. This program was administered by Oak Ridge Institute for Science and Education through an interagency agreement between the NIH and the U.S. Department of Energy. J. Ohayon, G. Cloutier and G. Finet were supported by grants from the Région Rhône-Alpes (2010–2013), the Agence Nationale de la Recherche (ANR), France (ATHEBIOMECH project # 06-BLANC-0263), and by the collaborative health research joint program of the Natural Sciences and Engineering Research Council of Canada (NSERC #323405-06) and Canadian Institutes of Health Research (CIHR #CPG-80085). This research is now supported by a joint international program of the ANR (MELANII project # 09-BLANC-0423) and NSERC strategic grant #STPGP-381136-09.

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Authors and Affiliations

  1. Laboratory TIMC-IMAG/DyCTiM, UJF, CNRS UMR 5525, In3S, Grenoble, France

    Jacques Ohayon

  2. Polytech Annecy-Chambéry, University of Savoie, Le Bourget du Lac, France

    Jacques Ohayon

  3. Department of Hemodynamics and Interventional Cardiology, Hospices Civils de Lyon and Claude Bernard University Lyon 1, INSERM Unit 886, Lyon, France

    Gérard Finet

  4. Laboratory LMGC, CNRS UMR 5508, University of Montpellier II, Montpellier, France

    Simon Le Floc’h

  5. Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada

    Guy Cloutier

  6. Laboratory of Integrative Cardiovascular Imaging Science, National Institute of Diabetes Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA

    Ahmed M. Gharib, Julie Heroux & Roderic I. Pettigrew

  7. National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Building 31, Room 1C14, Bethesda, MD, 20892-2281, USA

    Roderic I. Pettigrew

Authors
  1. Jacques Ohayon
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  2. Gérard Finet
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  3. Simon Le Floc’h
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  4. Guy Cloutier
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  5. Ahmed M. Gharib
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  6. Julie Heroux
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  7. Roderic I. Pettigrew
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Corresponding author

Correspondence to Roderic I. Pettigrew.

Additional information

Associate Editor Gang Bao oversaw the review of this article.

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Ohayon, J., Finet, G., Le Floc’h, S. et al. Biomechanics of Atherosclerotic Coronary Plaque: Site, Stability and In Vivo Elasticity Modeling. Ann Biomed Eng 42, 269–279 (2014). https://doi.org/10.1007/s10439-013-0888-1

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  • DOI: https://doi.org/10.1007/s10439-013-0888-1

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