Regression analysis on prediction of carotid plaque rupture based on surface stress of fluid dynamics
Ma Kejie
Du Rui
Xu Yuhao
Luo Yifeng
Cao Zhihong
Li Yuefeng
Abstract：Objective To explore the relationship between carotid plaque surface stress and plaque rupture and its predictive value.Methods Sixty-seven patients with carotid atherosclerotic plaques admitted to Affiliated Yixing Hospital of Jiangsu University from January 2016 to De-cember 2020 were prospectively recruited in this study.All of them underwent head and neck CT angiography(CTA)during a 2-year follow-up period,and were categorized into ruptured group(16 patients)and unruptured group(51 patients)based on the follow-up results.The CTA images were used to construct 3D models of the vessels and obtain plaque morphological parameters,and computational fluid dynamics was applied to quantify the surface stresses at each site of the plaque.The differences of each stress parameter were compared between the 2 groups.Logistic re-gression analysis was employed to identify the independent influencing factors of carotid plaque rupture,ROC curve was plotted to analyze the predictive efficacy of plaque surface stress parame-ters on plaque rupture,and linear regression analysis was applied to determine the influencing fac-tors for plaque surface stress parameters.Results Older age,larger ratio of smoking history,ele-vated LDL-C level,and higher total plaque volume,top surface stress,and proximal bottom-top surface stress difference(△PBTSS)were observed in the ruptured group than the unruptured group(P＜0.05,P＜0.01).Multivariable logistic regression analysis showed that LDL-C(OR=1.855,95％CI:1.542-8.349,P=0.043)and △PBTSS(OR=1.041,95％CI:1.016-1.067,P=0.002)were independent risk factors for plaque rupture.ROC curve analysis showed that the AUC value of combination of LDL-C and △ PBTSS in predicting plaque rupture was 0.906(95％CI:0.819-0.992,P=0.000).Univariate linear regression analysis showed that plaque droop di-ameter(β=22.320,95％CI:10.607-34.033,P=0.000)and proximal slope(β=3.002,95％CI:1.188-4.815,P=0.002)were strongly associated with △PBTSS,and there was a significant in-teraction between them(β=4.117,95％CI:3.169-5.065,P=0.000).Conclusion Plaque surface stress is closely associated with plaque rupture,and is helpful in predicting the occurrence of ca-rotid plaque rupture.
Keywords：stressmechanicalhydrodynamicscerebral angiographycarotid plaque rupture
Publication Date：2024-04-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 404-408 )