Effect of tissue properties, shape and orientation of microcalcifications on vulnerable cap stability using different hyperelastic constitutive models

Cardoso, Luís; Kelly-Arnold, Adreanne; Maldonado, Natalia; Laudier, Damien M.; Weinbaum, Sheldon

doi:10.1016/j.jbiomech.2014.01.010

Cited by 62 publications

(48 citation statements)

References 27 publications

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“…A structural model with straightforward SEF (e.g., Holzapfel et al’s model) may be more efficient for FE simulations. Such SEFs have been employed in FE analysis for diseased coronary arteries (Holzapfel et al, 2005a; Cardoso et al, 2014). It noted that the two-layer models (accounts for individual layered microstructure) are typically used as the intima contributes negligible mechanical support for coronary arteries of normal animals, normal animals.…”

Section: Microstructure-based Mechanical Models Of Heathly Coronarymentioning

confidence: 99%

“…The most widely used constitutive models are homogenous models due to their relatively simple SEF (Chau et al, 2004; Conway et al, 2012; García et al, 2012; Cardoso et al, 2014). The study of Imoto et al (Imoto et al, 2005) examined the longitudinal structural determinants of plaque vulnerability by linear elastic orthotropic models, and revealed that most common rupture point is that the shoulder of the fibrous cap.…”

Section: Finite Element Analyses Of Atherosclerosis Coronary Arteriesmentioning

confidence: 99%

“…Therefore, an accurate prediction of local stress distribution is essential for assessment of vulnerable plaque stability. A recent study (Cardoso et al, 2014) evaluated the effects of tissue material properties and geometries on the stability of vulnerable cap by three different hyperelastic constitutive models: Neo-Hookean, Mooney-Rivlin model and Holzapfel’s model (Holzapfel et al, 2000). They pointed out that stress concentration factor depends on tissue properties, anisotropy, size and shape, all of which can only be accounted for by a structural mechanical model.…”

Section: Finite Element Analyses Of Atherosclerosis Coronary Arteriesmentioning

confidence: 99%

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Microstructure-based biomechanics of coronary arteries in health and disease

Chen

Kassab

2016

Journal of Biomechanics

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Coronary atherosclerosis is the major cause of mortality and disability in developed nations. A deeper understanding of mechanical properties of coronary arteries and hence their mechanical response to stress is significant for clinical prevention and treatment. Microstructure-based models of blood vessels can provide predictions of arterial mechanical response at the macro- and micro-mechanical level for each constituent structure. Such models must be based on quantitative data of structural parameters (constituent content, orientation angle and dimension) and mechanical properties of individual adventitia and media layers of normal arteries as well as change of structural and mechanical properties of atherosclerotic arteries. The microstructural constitutive models of healthy coronary arteries consist of three major mechanical components: collagen, elastin, and smooth muscle cells, while the models of atherosclerotic arteries should account for additional constituents including intima, fibrous plaque, lipid, calcification, etc. This review surveys the literature on morphology, mechanical properties, and microstructural constitutive models of normal and atherosclerotic coronary arteries. It also provides an overview of current gaps in knowledge that must be filed in order to advance this important area of research for understanding initiation, progression and clinical treatment of vascular disease. Patient-specific structural models are highlighted to provide diagnosis, virtual planning of therapy and prognosis when realistic patient-specific geometries and material properties of diseased vessels can be acquired by advanced imaging techniques.

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Section: Microstructure-based Mechanical Models Of Heathly Coronarymentioning

confidence: 99%

Section: Finite Element Analyses Of Atherosclerosis Coronary Arteriesmentioning

confidence: 99%

Section: Finite Element Analyses Of Atherosclerosis Coronary Arteriesmentioning

confidence: 99%

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Microstructure-based biomechanics of coronary arteries in health and disease

Chen

Kassab

2016

Journal of Biomechanics

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“…In marked contrast, biomechanical analysis [7, 8] has shown that small microcalcifications (μCalcs) in close proximity within the fibrous cap itself can lead to a 200–700% increase in local tissue stresses [9–12]. Such a stress accumulation in a region of cap thinning is more than sufficient to exceed the local tissue threshold required to explain the asymptomatic rupture of non-stenotic plaque [7–14]. …”

Section: Introductionmentioning

confidence: 99%

Imaging and analysis of microcalcifications and lipid/necrotic core calcification in fibrous cap atheroma

Maldonado

Kelly-Arnold

Laudier

et al. 2015

Int J Cardiovasc Imaging

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PURPOSE The presence of microcalcifications (μCalcs) > 5μm within the cap of human fibroatheroma has been shown to produce a 200–700% increase in peak circumferential stress, which can transform a stable plaque into a vulnerable one, whereas μCalcs < 5μm do not appear to increase risk. We quantitatively examine the possibility to distinguish caps with microcalcifications > 5μm based on the gross morphological features of fibroatheromas, and the correlation between the size and distribution of μCalcs in the cap and the calcification in the lipid/necrotic core beneath it. METHODS Atherosclerotic lesions (N=72) were imaged using HR-μCT at 2.1-μm resolution for detailed analysis of atheroma morphology and composition, and validated using non-decalcified histology. RESULTS At 2.1-μm resolution one observes four different patterns of calcification within the lipid/necrotic core, and is able to elucidate the 3D spatial progression of the calcification process using these four patterns. Of the gross morphological features identified, only minimum cap thickness positively correlated with the existence of μCalcs > 5μm in the cap. We also show that μCalcs in the cap accumulate in the vicinity of the lipid /necrotic core boundary with few on the lumen side of the cap. CONCLUSION HR-μCT enables three-dimensional assessment of soft tissue composition, lipid content, calcification patterns within lipid/necrotic cores and analysis of the axial progression of calcification within individual atheroma. The distribution of μCalcs within the cap is highly non-uniform and decreases sharply as one proceeds from the lipid pool/necrotic core boundary to the lumen.

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“…Two distinct forms of cardiovascular calcification predominate clinically – atherosclerotic vascular calcification and calcific aortic valve disease (CAVD) (3, 4). Size and morphology determines the impact of calcification on these cardiovascular tissues (5–10). We recently showed that in pathologic conditions cells within atherosclerotic plaques release specialized extracellular vesicles (~100 nm) that nucleate calcium phosphate mineral (11, 12).…”

Section: Introductionmentioning

confidence: 99%

Quantification of Calcified Particles in Human Valve Tissue Reveals Asymmetry of Calcific Aortic Valve Disease Development

Yabusaki

Hutcheson

Vyas

et al. 2016

Front. Cardiovasc. Med.

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Recent studies indicated that small calcified particles observable by scanning electron microscopy (SEM) may initiate calcification in cardiovascular tissues. We hypothesized that if the calcified particles precede gross calcification observed in calcific aortic valve disease (CAVD), they would exhibit a regional asymmetric distribution associated with CAVD development, which always initiates at the base of aortic valve leaflets adjacent to the aortic outflow in a region known as the fibrosa. Testing this hypothesis required counting the calcified particles in histological sections of aortic valve leaflets. SEM images, however, do not provide high contrast between components within images, making the identification and quantification of particles buried within tissue extracellular matrix difficult. We designed a new unique pattern-matching based technique to allow for flexibility in recognizing particles by creating a gap zone in the detection criteria that decreased the influence of non-particle image clutter in determining whether a particle was identified. We developed this flexible pattern particle-labeling (FpPL) technique using synthetic test images and human carotid artery tissue sections. A conventional image particle counting method (preinstalled in ImageJ) did not properly recognize small calcified particles located in noisy images that include complex extracellular matrix structures and other commonly used pattern-matching methods failed to detect the wide variation in size, shape, and brightness exhibited by the particles. Comparative experiments with the ImageJ particle counting method demonstrated that our method detected significantly more (p < 2 × 10−7) particles than the conventional method with significantly fewer (p < 0.0003) false positives and false negatives (p < 0.0003). We then applied the FpPL technique to CAVD leaflets and showed a significant increase in detected particles in the fibrosa at the base of the leaflets (p < 0.0001), supporting our hypothesis. The outcomes of this study are twofold: (1) development of a new image analysis technique that can be adapted to a wide range of applications and (2) acquisition of new insight on potential early mediators of calcification in CAVD.

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Effect of tissue properties, shape and orientation of microcalcifications on vulnerable cap stability using different hyperelastic constitutive models

Cited by 62 publications

References 27 publications

Microstructure-based biomechanics of coronary arteries in health and disease

Microstructure-based biomechanics of coronary arteries in health and disease

Imaging and analysis of microcalcifications and lipid/necrotic core calcification in fibrous cap atheroma

Quantification of Calcified Particles in Human Valve Tissue Reveals Asymmetry of Calcific Aortic Valve Disease Development

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