Circulation, Vol 83, 1764-1770, Copyright © 1991 by American Heart Association
RT Lee, AJ Grodzinsky, EH Frank, RD Kamm and FJ Schoen
BACKGROUND. Although thrombosis associated with a fissured atherosclerotic
plaque is believed to be the most common cause of acute coronary syndromes,
the underlying factors that trigger plaque rupture are currently unknown.
However, the mechanical behavior of the plaque is probably of critical
importance. METHODS AND RESULTS. To test the hypothesis that the mechanical
properties of a plaque are dependent on its composition and, in particular,
that the stiffness of fibrous caps changes within the range of frequencies
carried by a physiological pressure wave, the stress-strain relation was
studied in 27 fibrous caps and related to the underlying histological
structure of the fibrous cap. Fibrous caps were obtained during 14
autopsies from the abdominal aorta and were classified by histological
examination as cellular (n = 7), hypocellular (n = 9), or calcified (n =
11). Hypocellular fibrous caps were 1-2 times stiffer than cellular caps (p
less than 0.005), and calcified caps were 4-5 times stiffer than cellular
caps (p less than 0.005). All 27 fibrous caps demonstrated an increase in
stiffness with increasing frequencies of stress ranging from 0.05 to 10 Hz;
the increase in stiffness was similar in all three histological classes.
CONCLUSIONS. We conclude that the stiffness of fibrous caps from human
atherosclerotic plaques is related to the underlying histological structure
and that the stiffness increases with frequency in the range of
physiological heart rates. The protective benefit of beta-adrenergic
receptor blocking agents in coronary artery disease may, in part, be
related to the frequency dependence of atherosclerotic plaque stiffness.
ARTICLES
Structure-dependent dynamic mechanical behavior of fibrous caps from human atherosclerotic plaques
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
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