Microcalcifications Increase Coronary Vulnerable Plaque Rupture Potential: A Patient-Based Micro-CT Fluid–Structure Interaction Study

Annals of Biomedical Engineering, Vol. 40, No. 7, July 2012 (Ó 2012) pp. 1443–1454 DOI: 10.1007/s10439-012-0511-x

Microcalcifications Increase Coronary Vulnerable Plaque Rupture Potential: A Patient-Based Micro-CT Fluid–Structure Interaction Study S. H. RAMBHIA,1,2 X. LIANG,1 M. XENOS,1 Y. ALEMU,1 N. MALDONADO,3 A. KELLY,3 S. CHAKRABORTI,3 S. WEINBAUM,3 L. CARDOSO,3 S. EINAV,1,3 and DANNY BLUESTEIN1 1

Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA; 2School of Medicine, Stony Brook University, Stony Brook, NY, USA; and 3Department of Biomedical Engineering, The City College of the City University of New York, New York, NY, USA (Received 24 August 2011; accepted 6 January 2012; published online 11 January 2012) Associate Editor Aleksander S. Popel oversaw the review of this article.

United States annually.21 Acute myocardial infarction or sudden cardiac death, represented pathologically as arterial blockage with a thrombus overlying a vulnerable plaque (VP), is usually the primary clinical manifestation of severe coronary artery atherosclerosis.2 More specifically, the rupture of a vulnerable plaque is responsible for 60% of all myocardial infarction.23,24 Plaque morphology has been widely considered to play an important role in determining plaque vulnerability as well as clinical outcome.19,41 A typical VP is an atherosclerotic plaque covered by a thin fibrous cap, which can rupture, release underlying lipid components and activate platelets.27 Virmani et al.39,40 defined vulnerable plaque rupture as a thin fibrous cap