Universität zu Köln

Milzi, Andrea ORCID: 0000-0001-7580-8029, Lemma, Enrico Domenico ORCID: 0000-0002-5436-9175, Dettori, Rosalia, Burgmaier, Kathrin, Marx, Nikolaus, Reith, Sebastian and Burgmaier, Mathias (2021). Coronary plaque composition influences biomechanical stress and predicts plaque rupture in a morpho-mechanic OCT analysis. eLife, 10. CAMBRIDGE: ELIFE SCIENCES PUBLICATIONS LTD. ISSN 2050-084X

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Abstract

Plaque rupture occurs if stress within coronary lesions exceeds the protection exerted by the fibrous cap overlying the necrotic lipid core. However, very little is known about the biomechanical stress exerting this disrupting force. Employing optical coherence tomography (OCT), we generated plaque models and performed finite-element analysis to simulate stress distributions within the vessel wall in 10 ruptured and 10 non-ruptured lesions. In ruptured lesions, maximal stress within fibrous cap (peak cap stress [PCS]: 174 +/- 67 vs. 52 +/- 42 kPa, p<0.001) and vessel wall (maximal plaque stress [MPS]: 399 +/- 233 vs. 90 +/- 95 kPa, p=0.001) were significantly higher compared to non-ruptured plaques. Ruptures arose in the immediate proximity of maximal stress concentrations (angular distances: 21.8 +/- 30.3 degrees for PCS vs. 20.7 +/- 23.7 degrees for MPS); stress concentrations excellently predicted plaque rupture (area under the curve: 0.940 for PCS, 0.950 for MPS). This prediction of plaque rupture was superior to established vulnerability features such as fibrous cap thickness or macrophage infiltration. In conclusion, OCT-based finite-element analysis effectively assesses plaque biomechanics, which in turn predicts plaque rupture in patients. This highlights the importance of morpho-mechanic analysis assessing the disrupting effects of plaque stress.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Milzi, Andrea UNSPECIFIED orcid.org/0000-0001-7580-8029 UNSPECIFIED Lemma, Enrico Domenico UNSPECIFIED orcid.org/0000-0002-5436-9175 UNSPECIFIED Dettori, Rosalia UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgmaier, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Marx, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Reith, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgmaier, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-584654
DOI:	10.7554/eLife.64020
Journal or Publication Title:	eLife
Volume:	10
Date:	2021
Publisher:	ELIFE SCIENCES PUBLICATIONS LTD
Place of Publication:	CAMBRIDGE
ISSN:	2050-084X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPTICAL COHERENCE TOMOGRAPHY; CIRCUMFERENTIAL STRESS; CAP THICKNESS; ANGIOGRAPHY; STABILITY; FEATURES; DISEASE; LESIONS Multiple languages Biology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58465