ArticleAmerican journal of physiology. Heart and circulatory physiology2008
Necrotic core thickness and positive arterial remodeling index: emergent biomechanical factors for evaluating the risk of plaque rupture.
Article in American journal of physiology. Heart and circulatory physiology, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 1 of them a synthesis that pooled it.
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Who cites it
89 citing papers in PubMed, 1 synthesis or guideline pooled it.
- High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis.Angiology · 2021Pooled it
- Coronary CT Angiography-Based Prediction Model for Hemodynamically Significant Coronary Stenosis Integrating Morphological and Plaque Characteristics.Cardiovascular engineering and technology · 2026Article
- Biomechanics of Plaque Rupture and Cardiovascular Calcification.Advances in experimental medicine and biology · 2026Review
- Single-cell and spatial transcriptomics map senescent vascular cells in arterial remodeling during atherosclerosis in mice.Nature aging · 2025Article
- A Parameterized Cross-Sectional Model for Simulating Balloon Angioplasty in Atherosclerotic Arteries.International journal for numerical methods in biomedical engineering · 2025Article
- Evaluating the Influence of Morphological Features on the Vulnerability of Lipid-Rich Plaques During Stenting.Journal of biomechanical engineering · 2025Article
- Fully coupled hybrid in-silico modeling of atherosclerosis: A multi-scale framework integrating CFD, transport phenomena and agent-based modeling.Frontiers in bioengineering and biotechnology · 2025Article
- Combining Computational Fluid Dynamics, Structural Analysis, and Machine Learning to Predict Cerebrovascular Events: A Mild ML Approach.Diagnostics (Basel, Switzerland) · 2024Article
- A novel rabbit model of atherosclerotic vulnerable plaque established by cryofluid-induced endothelial injury.Scientific reports · 2024Article
- The interplay of collagen, macrophages, and microcalcification in atherosclerotic plaque cap rupture mechanics.Basic research in cardiology · 2024Review
- Validation of biomechanical assessment of coronary plaque vulnerability based on intravascular optical coherence tomography and digital subtraction angiography.Quantitative imaging in medicine and surgery · 2024Article
- Application of optical coherence tomography in cardiovascular diseases: bibliometric and meta-analysis.Frontiers in cardiovascular medicine · 2024Review
- Cardiac Computed Tomography Angiography in CAD Risk Stratification and Revascularization Planning.Diagnostics (Basel, Switzerland) · 2023Review
- Comparing Focused-Tracked and Plane Wave-Tracked ARFI Log(VoA) In Silico and in Application to Human Carotid Atherosclerotic Plaque, Ex Vivo.IEEE transactions on ultrasonics, ferroelectrics, and frequency control · 2023Article
- DPP4 inhibition impairs senohemostasis to improve plaque stability in atherosclerotic mice.The Journal of clinical investigation · 2023Article
- Size and proximity of micro-scale hard-inclusions increase the risk of rupture in fibroatheroma-like laboratory models.Journal of the mechanical behavior of biomedical materials · 2023Article
- Healing the Ischaemic Heart: A Critical Review of Stem Cell Therapies.Reviews in cardiovascular medicine · 2023Review
- Characterizing atherosclerotic tissues:Frontiers in bioengineering and biotechnology · 2023Article
- Transcoronary stem cell transfer and evolution of infarct-related artery atherosclerosis: evaluation with conventional and novel imaging techniques including Quantitative Virtual Histology (qVH).Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2022Article
- The Need to Shift from Morphological to Structural Assessment for Carotid Plaque Vulnerability.Biomedicines · 2022Article
29 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fibrous cap thickness is often considered as diagnostic of the degree of plaque instability. Necrotic core area (Core(area)) and the arterial remodeling index (Remod(index)), on the other hand, are difficult to use as clinical morphological indexes: literature data show a wide dispersion of Core(area) thresholds above which plaque becomes unstable. Although histopathology shows a strong correlation between Core(area) and Remod(index), it remains unclear how these interact and affect peak cap stress (Cap(stress)), a known predictor of rupture. The aim of this study was to investigate the change in plaque vulnerability as a function of necrotic core size and plaque morphology. Cap(stress) value was calculated on 5,500 idealized atherosclerotic vessel models that had the original feature of mimicking the positive arterial remodeling process described by Glagov. Twenty-four nonruptured plaques acquired by intravascular ultrasound on patients were used to test the performance of the associated idealized morphological models. Taking advantage of the extensive simulations, we investigated the effects of anatomical plaque features on Cap(stress). It was found that: 1) at the early stages of positive remodeling, lesions were more prone to rupture, which could explain the progression and growth of clinically silent plaques and 2) in addition to cap thickness, necrotic core thickness, rather than area, was critical in determining plaque stability. This study demonstrates that plaque instability is to be viewed not as a consequence of fibrous cap thickness alone but rather as a combination of cap thickness, necrotic core thickness, and the arterial remodeling index.
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