ArticleAmerican journal of physiology. Heart and circulatory physiology2012
A mechanistic analysis of the role of microcalcifications in atherosclerotic plaque stability: potential implications for plaque rupture.
Article in American journal of physiology. Heart and circulatory physiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 116 papers, 2 of them syntheses that pooled it.
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Who cites it
116 citing papers in PubMed, 2 syntheses or guidelines pooled it, 242 citations in OpenAlex.
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- Carotid plaque mechanical heterogeneity and stroke risk: a comprehensive study integrating multi-site viscoelastic analysis and RADS classification.BMC cardiovascular disorders · 2026Article
- Coronary Artery Calcification: From Molecular Mechanisms to Interventional Strategies.International journal of molecular sciences · 2026Review
- Microcalcification: Effects on Atherosclerotic Vulnerable Plaques, Detection, and Therapeutic Perspectives.Current atherosclerosis reports · 2026Review
- Biomechanics of Plaque Rupture and Cardiovascular Calcification.Advances in experimental medicine and biology · 2026Review
- Medial arterial calcification in ageing and disease: current evidence and knowledge gaps.European heart journal · 2025Review
- AI-based modality-agnostic classification system for vascular calcifications.Scientific reports · 2025Article
- Modulating vascular stresses through homeostatic remodelling: a multi-patient analysis of atherosclerotic carotid biomechanics.Journal of the Royal Society, Interface · 2025Article
- Current status and challenges of multi-omics research using animal models of atherosclerosis.Journal of molecular and cellular cardiology plus · 2025Review
- Effect of metabolic syndrome on coronary artery atherosclerotic plaque in type 2 diabetes mellitus patients.Frontiers in endocrinology · 2025Article
- Investigating the impact of microcalcification size and volume on collagenous matrix and tissue mechanics using a tissue-engineered atherosclerotic cap model.Frontiers in cardiovascular medicine · 2025Article
- Carotid atherosclerotic plaque microcalcification is independently associated with recurrent neurovascular events: A pilot study.International journal of stroke : official journal of the International Stroke Society · 2024Article
- Carotid artery calcium score: Definition, classification, application, and limits.The neuroradiology journal · 2024Article
- Computational Investigation of Vessel Injury Due to Catheter Tracking During Transcatheter Aortic Valve Replacement.Annals of biomedical engineering · 2024Article
- Molecular Pathways of Vulnerable Carotid Plaques at Risk of Ischemic Stroke: A Narrative Review.International journal of molecular sciences · 2024Review
- The interplay of collagen, macrophages, and microcalcification in atherosclerotic plaque cap rupture mechanics.Basic research in cardiology · 2024Review
- The Significance of Coronary Artery Calcification for Percutaneous Coronary Interventions.Healthcare (Basel, Switzerland) · 2024Review
- Association of NPC1L1 and HMGCR gene polymorphisms with coronary artery calcification in patients with premature triple-vessel coronary disease.BMC medical genomics · 2024Article
56 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 1 country.
Funding
Abstract
The role of microcalcifications (μCalcs) in the biomechanics of vulnerable plaque rupture is examined. Our laboratory previously proposed (Ref. 44), using a very limited tissue sample, that μCalcs embedded in the fibrous cap proper could significantly increase cap instability. This study has been greatly expanded. Ninety-two human coronary arteries containing 62 fibroatheroma were examined using high-resolution microcomputed tomography at 6.7-μm resolution and undecalcified histology with special emphasis on calcified particles <50 μm in diameter. Our results reveal the presence of thousands of μCalcs, the vast majority in lipid pools where they are not dangerous. However, 81 μCalcs were also observed in the fibrous caps of nine of the fibroatheroma. All 81 of these μCalcs were analyzed using three-dimensional finite-element analysis, and the results were used to develop important new clinical criteria for cap stability. These criteria include variation of the Young's modulus of the μCalc and surrounding tissue, μCalc size, and clustering. We found that local tissue stress could be increased fivefold when μCalcs were closely spaced, and the peak circumferential stress in the thinnest nonruptured cap (66 μm) if no μCalcs were present was only 107 kPa, far less than the proposed minimum rupture threshold of 300 kPa. These results and histology suggest that there are numerous μCalcs < 15 μm in the caps, not visible at 6.7-μm resolution, and that our failure to find any nonruptured caps between 30 and 66 μm is a strong indication that many of these caps contained μCalcs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.