动脉粥样硬化斑块疲劳破坏的生物力学机理研究

Rupture of atherosclerotic plaques is the major cause of stroke and heart attack. Early detection and diagnosis of vulnerable plaques pre rupture is crucial for the risk stratification of patients with cardiovascular diseases. Different from the current available studies which are mainly focused on wall stress and wall shear stress, the proposed project aims to investigate the impact of the natural fatigue environment of cardiovascular system on plaque vulnerability. ApoE-/- mice atherosclerosis model and patients with coronary diseases will be studies by combining optical coherence tomography (OCT) , magnetic resonance imaging (MRI), numerical simulation, mechanical test and pathological analysis to investigate the mechanism of plaque fatigue rupture. Plaque fatigue model will be developed to quantify the role of plaque microstructure, the mechanical properties of plaque components and the fatigue environment on plaque vulnerability. A patient-specific and image-based biomechanical modeling technique will be developed in order to provide a framework for vulnerable plaque identification. Image-based three-dimensional computational models with multi-component plaque structure will be developed and solved numerically to simulate plaque rupture path and fatigue life. New risk indicators for vulnerable plaques will be identified for more accurate plaque assessment. Success of this project may lead to a better understanding of the underlying fatigue mechanism of plaque progression and rupture. It may provide us a useful clinical tool for the identification of high-risk patients with cardiovascular diseases, followed by large-scale patient follow-up studies.

动脉粥样硬化斑块破裂是急性冠状动脉综合症和脑卒中等血管疾病发生的主要原因。易损斑块的早期识别和诊断是防治心脑血管疾病的关键。与已有的基于血管壁应力、流体剪切应力等研究角度不同，本项目将针对"血管天然的疲劳环境会对斑块的稳定性产生怎样的影响？"这一核心问题。以临床病人为研究对象，采用光学干涉断层成像、核磁成像、数值模拟、力学实验和生物实验相结合的技术路线，从疲劳裂纹生长及疲劳寿命的角度建立动脉粥样硬化斑块的生物力学模型，探索斑块的形态结构、材料性能以及疲劳环境对斑块易损性的影响。进一步发展基于医学影像的病人个体化生物力学建模和计算方法系统，为易损斑块的量化判定以及风险评估提供理论基础和技术手段。项目的成功开展将有助于我们深入了解斑块破坏的疲劳机理，并进一步根据病人随访数据评价风险因子的可预测性，为将来的临床实践提供新思路。

动脉粥样硬化斑块破裂是急性冠状动脉综合症和脑卒中等血管疾病发生的主要原因。易损斑块的早期识别和诊断是防治心脑血管疾病的关键。与已有的基于血管壁应力、流体剪切应力等研究角度不同，本项目主要针对"血管天然的疲劳环境会对斑块的稳定性产生怎样的影响？"这一核心问题。以临床病人为研究对象，采用光学干涉断层成像、核磁成像和数值模拟相结合的技术路线，从疲劳裂纹生长及疲劳寿命的角度建立了动脉粥样硬化斑块的生物力学模型，探索了斑块的形态结构、材料性能以及疲劳环境对斑块易损性的影响。进一步发展了基于医学影像的病人个体化生物力学建模和计算方法系统，为易损斑块的量化判定以及风险评估提供了理论基础和技术手段。项目的开展深入了我们对斑块破坏的疲劳机理的认识，为将来的临床实践提供了新思路。项目在两年里开展顺利，共发表论文11篇，培养研究生6名。