Heart attack is caused when there is rupture of an atherosclerotic plaque lining an artery to the heart. It is the No.1 killer in the UK. Although cardiologists take pictures of these plaques to determine how large they are, we also need to identify plaques that will rupture compared with those that won’t. Collaborating with Professor Martin R Bennett in the Department of Medicine, Dr Zhongzhao Teng and his team members are developing techniques that calculate the stress that plaques are under, to both identify plaques at highest risk of rupture, and guide patient treatment.
The relative study, ‘Development of 3D finite element analysis and imaging to predict human atherosclerotic plaque instability’, was recently funded by BHF. Researchers in Cambridge have collected a cohort patient data using virtual histology intravascular ultrasound (VH-IVUS). This study will further develop the biomechanical technique of 3D finite element analysis (FEA) for VH-IVUS, which allows estimation of plaque structural stress (PSS) and wall shear stress (WSS). The main aim is to identify higher PSS in high-risk regions in plaques of patients presenting with acute coronary syndrome compared with stable angina, and in patients who experienced major adverse cardiovascular events (MACE). Researchers will determine whether integration of 3D PSS and WSS improves MACE prediction.
This multidisciplinary study brings expertise from mechanical engineering, cardiology, and computer science under one roof to tackle an increasing challenge we are currently facing. The success of this study will help to identify the right patient at a right time to save lives.
Brown AJ, Teng Z, Evans PC, Gillard JH, Samady H, Bennett MR. Role of biomechanical forces in the natural history of coronary atherosclerosis. Nat Rev Cardiol. 2016;13(4): 210-220.