Abstract:
Coronary heart disease (CHD) is characterized by the narrowing of coronary arteries and is one of the leading causes of death in today’s century. The main cause of CHD is atherosclerosis jots down to the deposition of fat, cholesterol, calcium, and other deposits (collectively called plaque) along the inner lining of the vessel wall. Plaque material and structural characteristics are important factors in the natural progression of the disease and has an important clinical predictive value. Extensive calcification most likely represents a later stage of atherosclerosis and is not only an independent predictor of CHD, but also has prognostic significance in patients with known CHD. The social and economic burden of this disease remains very high. It is important to understand the cause and consequences of CHD.
The main objective of this study is to investigate the role of hemodynamically induced biomechanical forces in predicting the mechanical strength of stage ѵ atherosclerotic coronary artery. The uniqueness of this study is coupling of two different techniques (Struture Mechanics and FSI) to investigate plaque burdened coronary vessels.
Author has utilized numerical methods and techniques in computational mechanics and Biomedical Engineering to investigate the synergy of CHD. Three-dimensional image based models of normal and atherosclerotic vessel were built using image processing and a computer solvers. These models were then utilized for the quantification of structural forces induced by the underlying blood flow in a virtual reality set up using Finite Element Modeling. In addition, FSI coupling approach was also employed to address blood-vessel-plaque-simulation. Calcium score was calculated using an algorithm to evaluate its contribution in overall plaque burden. The results obtained validated and compared with the previous literature.
Our results show an increased stiffness and Wall Shear Stress (WSS) in atherosclerotic arteries compared to the healthy ones. Large curvatures under torsional loading are found to be the regions where maximum stress is accumulated making them more vulnerable to the plaque formation &lesions in normal arteries. Moreover, larger strain rates were recorded in healthy arteries and fibrous plaque was found to exhibit stiffest response to loading than calcified lesions. Coronary Artery Calcium Score (CACS) yielded a positive correlation with atherosclerosis and pose a moderate risk of suffering an acute CHD event in the near future.
