High pressure-driven mechanical wall stress was associated with a reduction in carotid plaque thickness (p<0.001) and, alongside low oscillatory shear index, greater calcification increase (p<0.001).
Observational (n=75)
Do pressure-driven and flow-driven biomechanical factors associate with structural changes in carotid atherosclerosis over time?
75 symptomatic patients (150 carotid arteries) with mild-to-moderate stenosis from the Plaque-At-Risk study
Assessment of local baseline biomechanical factors (pressure-driven mechanical wall stress [MWS] and flow-driven factors [OSI, TAWSS]) using fluid-structure interaction (FSI) computational models
Structural changes in carotid wall and calcifications over 2 yearssurrogate
Pressure-driven mechanical wall stress and flow-driven shear stress factors significantly correlate with the progression of calcified and non-calcified carotid plaques over 2 years.
p-value: p=<0.001
BACKGROUND AND AIMS: Local biomechanical factors are known to influence atherosclerosis in extracranial carotid arteries. While the role of some flow-driven biomechanical factors has been investigated, the influence of pressure-driven mechanical wall stress (MWS) has received limited attention. In this study, the association of the pressure-driven and flow-driven biomechanical factors with carotid atherosclerosis was examined. METHODS: Carotid arteries (n = 150) with mild-to-moderate stenosis from 75 symptomatic patients (Plaque-At-Risk study) were imaged using multi-detector computed tomography angiography (MDCTA) at the time of inclusion and after 2 years. Structural changes in carotid wall and calcifications were quantified from MDCTA data while the local baseline biomechanical factors in the carotids were determined using fluid-structure interaction (FSI) computational models. The associations of the local pressure-driven and flow-driven biomechanical factors with the carotid wall and calcification changes were studied using Generalized Linear Mixed models. RESULTS: Over two years, plaque sectors, with calcified and non-calcified sectors combined, exhibited minimal change in wall thickness, likely due to medical treatment. High MWS was associated (p < 0.001) with a reduction in plaque thickness. In calcified plaque sectors, high MWS and low oscillatory shear index (OSI) were associated (p < 0.001) with greater calcification thickness increase. The distance between the lumen and calcification decreased over time, especially in the sectors exposed to high time-averaged wall shear stress (TAWSS) and high MWS. CONCLUSIONS: Our results suggest that the pressure-driven local MWS and flow-driven OSI and TAWSS significantly correlate with the development of calcified and non-calcified plaques in carotid arteries. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01208025.
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Aikaterini Tziotziou
Erasmus MC Cancer Institute
Yanjing Liu
The Affiliated Hospital to Changchun University of Chinese Medicine
Federica Fontana
Erasmus MC
Atherosclerosis
University of Amsterdam
Utrecht University
Erasmus University Rotterdam
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Tziotziou et al. (Thu,) conducted a observational in Carotid atherosclerosis (n=75). Pressure-driven mechanical wall stress and flow-driven biomechanical factors was evaluated on Structural changes in carotid wall and calcifications (p=<0.001). High pressure-driven mechanical wall stress was associated with a reduction in carotid plaque thickness (p<0.001) and, alongside low oscillatory shear index, greater calcification increase (p<0.001).
synapsesocial.com/papers/6a0fa2fb9e54838161fcfbee — DOI: https://doi.org/10.1016/j.atherosclerosis.2025.120415
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