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Prediction of events based on biomechanical parameters

Prediction of events based on biomechanical parameters

Project Investigators: Blerim Mujaj Jolanda Wentzel , Meike Vernooij, Aad van der Lugt (Radiology)

To identify subjects at high risk of stroke, several models to predict risk have been proposed, but these mainly involve systemic parameters of atherosclerosis. Atherosclerosis, however, is a very localized disease and neurovascular events result mainly from localized plaque related problems, including plaque rupture or embolization from plaque ulcer. Novel plaque-specific indicators in addition to overall level of atherosclerosis are required to improve selection of subjects at increased risk of stroke. Biomechanical parameters, like wall stress and shear stress, have been found to be crucial for plaque rupture and embolization. Rupture-prone plaques are characterized by their specific morphology and composition. When a plaque ruptures, the thrombogenic lipid material comes in contact with blood, which triggers the blood coagulation. Plaque rupture is the result of wall stress exceeding the strenght of the fibrous cap of the atherosclerotic plaque.

In close collaboration with the Epidemiology department (prof. J. Witteman) and Radiology department (prof. A van der Lugt), we study the following research questions in a large population:

(1) Can we identify local biomechanical parameters in the carotid bifurcation that predict the risk of stroke in a general population ?

(2) Do these parameters have additional predictive value to currently used measures of atherosclerosis?