Fluid-structure interaction models based on patient-specific IVUS at baseline and follow-up for prediction of coronary plaque progression by morphological and biomechanical factors: A preliminary study |
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| Institution: | 1. School of Biological Science and Medical Engineering, Southeast University, Nanjing, China;2. Mathematical Sciences Department, Worcester Polytechnic Institute, MA, USA;3. Columbia University, The Cardiovascular Research Foundation, NY, NY, USA;4. Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA;5. Cardiovascular Division, Washington University School of Medicine, St. Louis, MO, USA;6. Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA;1. School of Biological Science and Medical Engineering, Southeast University, Nanjing, China;2. Mathematical Sciences Department, WPI, Worcester, MA 01609, USA;3. Network Technology Research Institute, China United Network Comm. Co., Ltd., Beijing, China;4. Department of Radiology, Translational and molecular imaging institute, Icahn School of Medicine at Mount Sinai, New York, USA;5. Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA;6. Department of Radiology, University of Cambridge, CB2 0QQ, United Kingdom;1. Biomedical Engineering, National University of Ireland Galway, Galway, Ireland;2. Department of Vascular and Endovascular Surgery, National University of Ireland Galway, Galway, Ireland;1. Biomechanics and Implants Research Group, Medical Device Research Institute, College of Science and Engineering, Flinders University, South Australia, Australia;2. Flinders Centre for Nanoscale Science and Technology, College of Science and Engineering, Flinders University, South Australia, Australia;2. Key Laboratory for Biomechanics and Mechanobiology of the Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, People’s Republic of China;3. SuperComputing Applications and Innovation Department – SCAI, CINECA, Milan, Italy;4. IBFM, Research National Council, Milan, Italy |
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| Abstract: | Plaque morphology and biomechanics are believed to be closely associated with plaque progression. In this paper, we test the hypothesis that integrating morphological and biomechanical risk factors would result in better predictive power for plaque progression prediction. A sample size of 374 intravascular ultrasound (IVUS) slices was obtained from 9 patients with IVUS follow-up data. 3D fluid-structure interaction models were constructed to obtain both structural stress/strain and fluid biomechanical conditions. Data for eight morphological and biomechanical risk factors were extracted for each slice. Plaque area increase (PAI) and wall thickness increase (WTI) were chosen as two measures for plaque progression. Progression measure and risk factors were fed to generalized linear mixed models and linear mixed-effect models to perform prediction and correlation analysis, respectively. All combinations of eight risk factors were exhausted to identify the optimal predictor(s) with highest prediction accuracy defined as sum of sensitivity and specificity. When using a single risk factor, plaque wall stress (PWS) at baseline was the best predictor for plaque progression (PAI and WTI). The optimal predictor among all possible combinations for PAI was PWS + PWSn + Lipid percent + Min cap thickness + Plaque Area (PA) + Plaque Burden (PB) (prediction accuracy = 1.5928) while Wall Thickness (WT) + Plaque Wall Strain (PWSn) + Plaque Area (PA) was the best for WTI (1.2589). This indicated that PAI was a more predictable measure than WTI. The combination including both morphological and biomechanical parameters had improved prediction accuracy, compared to predictions using only morphological features. |
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| Keywords: | Coronary Fluid–structure interaction Plaque progression IVUS Follow-up study |
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