Numerical study of biomechanical characteristics of plaque rupture at stenosed carotid bifurcation:a stenosis mechanical property-specific guide for blood pressure control in daily activities  

作　　者：Shaoxiong Yang Qinghu Wang Weihao Shi Wencheng Guo Zonglai Jiang Xiaobo Gong 

机构地区：[1]Key Laboratory of Hydrodynamics(Ministry of Education),Department of Engineering Mechanics,School of Naval Architecture,Ocean and Civil Engineering,Shanghai Jiao Tong University,Shanghai 200240,China [2]Department of Vascular Surgery,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China [3]Institute of Mechanobiology and Biomedical Engineering,School of Life Sciences and Biotechnology,Shanghai Jiao Tong University,Shanghai 200240,China

出　　处：《Acta Mechanica Sinica》2019年第6期1279-1289,共11页力学学报（英文版）

基　　金：This work was supported by the National Key R&D Program of China(Grant 2017YFE0117100);the National Natural Science Foundation of China(Grants 11872040 and 11232010);the Outstanding Clinical Discipline Project of Shanghai Pudong(Grant PWYgy-2018-08);the Science and Technology Commission of Shanghai Municipality(Grant 18ZR1433900).

摘　　要：Acute stress concentration plays an important role in plaque rupture and may cause stroke or myocardial infarction.Quantitative evaluation of the relation between in vivo plaque stress and variations in blood pressure and flow rates is valuable to optimize daily monitoring of the cardiovascular system for high-risk patients as well as to set a safe physical exercise intensity for better quality of life.In this study,we constructed an in vivo stress model for a human carotid bifurcation with atherosclerotic plaque,and analyzed the effects of blood pressure,flow rates,plaque stiffness,and stenosis on the elastic stress and fluid viscous stress around the plaque.According to the maximum values of the mechanical stress,we define a risk index to predict the risk level of plaque rupture under different exercise intensities.For a carotid bifurcation where the blood flow divides,the results suggest that the stenosis ratio determines the ratio of the contributions of elastic shear stress and viscous shear stress to plaque rupture.A n increase of the plaque stiffness enhances the maximum elastic shear stress in the plaque,indicating that a high-stiffness plaque is more prone to rupture for given stenosis ratio.High stress co-localization at the shoulder of plaques agrees with the region of plaque injury in clinical observations.It is demonstrated that,due to the stress-shield effect,the rupture risk of a high-stiffness plaque tends to decrease under high-stenosis conditions,suggesting the existence of a specific stenosis corresponding to the maximum risk.This study may help to complement risk stratification of vulnerable plaques in clinical practice and provides a stenosis mechanical property-specific guide for blood pressure control in cardiovascular health management.

关 键 词：Stenosed carotid bifurcation In vivo stress Plaque rupture Risk stratification Blood pressure control 

分 类 号：O17[理学—数学]