Anisotropic mechanical properties of tissue components in human atherosclerotic plaques.

Knowledge of the biomechanical properties of human atherosclerotic plaques is of essential importance for developing more insights in the pathophysiology of the cardiovascular system and for better predicting the outcome of interventional treatments such as balloon angioplasty. Available data are mainly based on uniaxial tests, and most of the studies investigate the mechanical response of fibrous plaque caps only. However, stress distributions during, for example, balloon angioplasty are strongly influenced by all components of atherosclerotic lesions. A total number of 107 samples from nine human high-grade stenotic iliac arteries were tested; associated anamnesis of donors reported. Magnetic resonance imaging was employed to test the usability of the harvested arteries. Histological analyses has served to characterize the different tissue types. Prepared strips of 7 different tissue types underwent cyclic quasistatic uniaxial tension tests in axial and circumferential directions; ultimate tensile stresses and stretches were documented. Experimental data of individual samples indicated anisotropic and highly nonlinear tissue properties as well as considerable interspecimen differences. The calcification showed, however a linear property, with about the same stiffness as observed for the adventitia in high stress regions. The stress and stretch values at calcification fracture are smaller (179 +/- 56 kPa and 1.02 +/- 0.005) than for each of the other tissue components. Of all intimal tissues investigated, the lowest fracture stress occurred in the circumferential direction of the fibrous cap (254.8 +/- 79.8 kPa at stretch 1.182 +/- 0.1). The adventitia demonstrated the highest and the nondiseased media the lowest mechanical strength on average.

[1]  G. Andros,et al.  Assessing and modifying the vulnerable atherosclerotic plaque: Valentin Fuster; Armonk, NY; 2002 Futura; 379 pages; $144.95 , 2004 .

[2]  Gerhard A. Holzapfel,et al.  A Layer-Specific Three-Dimensional Model for the Simulation of Balloon Angioplasty using Magnetic Resonance Imaging and Mechanical Testing , 2002, Annals of Biomedical Engineering.

[3]  Peter D. Richardson,et al.  Biomechanics of Plaque Rupture: Progress, Problems, and New Frontiers , 2002, Annals of Biomedical Engineering.

[4]  Gerhard A Holzapfel,et al.  Passive biaxial mechanical response of aged human iliac arteries. , 2003, Journal of biomechanical engineering.

[5]  Renu Virmani,et al.  Pathology of the thin-cap fibroatheroma: a type of vulnerable plaque. , 2003, Journal of interventional cardiology.

[6]  D. Atkins,et al.  American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. , 2003, Circulation.

[7]  G A Holzapfel,et al.  Determination of constitutive equations for human arteries from clinical data. , 2003, Journal of biomechanics.

[8]  R D Kamm,et al.  On the sensitivity of wall stresses in diseased arteries to variable material properties. , 2003, Journal of biomechanical engineering.

[9]  Peter W. F. Wilson,et al.  Atlas of Atherosclerosis , 2003, Current Medicine Group.

[10]  C. Kramer.  Magnetic resonance imaging to identify the high-risk plaque. , 2002, The American journal of cardiology.

[11]  M. Epstein,et al.  Cardiovascular Solid Mechanics: Cells, Tissues, and Organs , 2002 .

[12]  Peter Regitnig,et al.  Mechanics of the human femoral adventitia including the high-pressure response. , 2002, American journal of physiology. Heart and circulatory physiology.

[13]  V. Fuster,et al.  Intimomedial Interface Damage and Adventitial Inflammation Is Increased Beneath Disrupted Atherosclerosis in the Aorta: Implications for Plaque Vulnerability , 2002, Circulation.

[14]  J. Humphrey,et al.  Compressive stress-relaxation of human atherosclerotic plaque. , 2001, Journal of Biomedical Materials Research.

[15]  G. Holzapfel,et al.  Mechanics of Angioplasty: Wall, Balloon and Stent , 2000, Mechanics in Biology.

[16]  L. Topoleski,et al.  Mechanical behavior of calcified plaques: a summary of compression and stress-relaxation experiments , 2000, Zeitschrift für Kardiologie.

[17]  J. Humphrey,et al.  Composition- and history-dependent radial compressive behavior of human atherosclerotic plaque. , 1997, Journal of biomedical materials research.

[18]  Salunke Nv,et al.  Biomechanics of atherosclerotic plaque. , 1997 .

[19]  L. Topoleski,et al.  Biomechanics of atherosclerotic plaque. , 1997, Critical reviews in biomedical engineering.

[20]  L. Demer.  A skeleton in the atherosclerosis closet. , 1995, Circulation.

[21]  L. Gibson,et al.  Static circumferential tangential modulus of human atherosclerotic tissue. , 1994, Journal of biomechanics.

[22]  R D Kamm,et al.  Mechanical properties of model atherosclerotic lesion lipid pools. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[23]  R. Kamm,et al.  Distribution of Circumferential Stress in Ruptured and Stable Atherosclerotic Lesions A Structural Analysis With Histopathological Correlation , 1993, Circulation.

[24]  M J Davies,et al.  Testing of small connective tissue specimens for the determination of the mechanical behaviour of atherosclerotic plaques. , 1993, Journal of biomedical engineering.

[25]  Barbara Norton McCord.  Fatigue of atherosclerotic plaque , 1992 .

[26]  R D Kamm,et al.  Effects of fibrous cap thickness on peak circumferential stress in model atherosclerotic vessels. , 1992, Circulation research.

[27]  F J Schoen,et al.  Prediction of mechanical properties of human atherosclerotic tissue by high-frequency intravascular ultrasound imaging. An in vitro study. , 1992, Arteriosclerosis and thrombosis : a journal of vascular biology.

[28]  A. Grodzinsky,et al.  Structure‐Dependent Dynamic Mechanical Behavior of Fibrous Caps From Human Atherosclerotic Plaques , 1991, Circulation.

[29]  M. Davies,et al.  Atherosclerotic plaque caps are locally weakened when macrophages density is increased. , 1991, Atherosclerosis.

[30]  R. Hickler,et al.  Aortic and large artery stiffness: Current methodology and clinical correlations , 1990, Clinical cardiology.

[31]  P. Richardson,et al.  Mechanical Properties of Human Atherosclerotic Lesions , 1990 .

[32]  G. V. R. Born,et al.  INFLUENCE OF PLAQUE CONFIGURATION AND STRESS DISTRIBUTION ON FISSURING OF CORONARY ATHEROSCLEROTIC PLAQUES , 1989, The Lancet.

[33]  M. Davies,et al.  Mechanical testing of connective tissue in the search for determinants of atherosclerotic plaque cap rupture , 1988 .

[34]  Johannes A. G. Rhodin,et al.  Architecture of the Vessel Wall , 1980 .

[35]  S. Fowler,et al.  The subcellular biochemistry of human arterial lesions. I. Biochemical constituents and marker enzymes in diseased and unaffected portions of human aortic specimens. , 1979, Experimental and molecular pathology.