Fatigue and plaque rupture in myocardial infarction

Antheunis Versluis, Alan J. Bank, William H. Douglas

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Plaque rupture plays a role in the majority of acute coronary syndromes. Rupture has been associated with stress concentrations, which are affected by tissue properties and anatomy. In this study rupture was not approached as an acute syndrome, but rather as the culmination of a chronic injury or fatigue process. The aim of our study was to investigate the impact of anatomy, tissue properties, and blood pressure on a fatigue mechanism. Incremental crack propagation was dynamically simulated based on evolving stress distributions. Stresses were resolved by a finite element solver, using vessel stiffness properties derived from in vivo data. Plaque fatigue crack growth per pressure pulse was estimated using an adapted Paris-relation. It was demonstrated that cracks begin at the lumen wall at areas of stress concentration, depending on the shape of the lumen, thickness of the fibrous cap and stiffness of the plaque components. Mean or pulse pressure did not affect initiation location. Cracks extended radially and grew at a rate that was highly dependent on both mean and pulse pressure and on lipid stiffness. Rupture rate depended on blood pressure and lipid stiffness. It was concluded that a fatigue mechanism in a pulsatile cardiovascular pressure environment reconciles clinical evidence of acute plaque rupture at seemingly low stress levels, and it could provide a framework for developing strategies to create a biomechanically benign environment which is least conducive to plaque rupture.

Original languageEnglish (US)
Pages (from-to)339-347
Number of pages9
JournalJournal of Biomechanics
Volume39
Issue number2
DOIs
StatePublished - Jan 1 2006

Fingerprint

Fatigue
Rupture
Myocardial Infarction
Stiffness
Fatigue of materials
Stress concentration
Blood Pressure
Blood pressure
Lipids
Tissue
Cracks
Anatomy
Fatigue crack propagation
Crack propagation
Paris
Acute Coronary Syndrome
Pressure
Wounds and Injuries
Growth

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Orthopedics and Sports Medicine
  • Biomedical Engineering
  • Rehabilitation

Cite this

Fatigue and plaque rupture in myocardial infarction. / Versluis, Antheunis; Bank, Alan J.; Douglas, William H.

In: Journal of Biomechanics, Vol. 39, No. 2, 01.01.2006, p. 339-347.

Research output: Contribution to journalArticle

Versluis, Antheunis ; Bank, Alan J. ; Douglas, William H. / Fatigue and plaque rupture in myocardial infarction. In: Journal of Biomechanics. 2006 ; Vol. 39, No. 2. pp. 339-347.
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