Enhanced External Counterpulsation Treatment Inhibitting Advanced Atherosclerotic Plaque Progression by Augmenting the Plaque Wall Stress： An in vivo FSI Study Based on Animal Experiment

Enhance extemal counterpulsation （ECP） procedure has exhbited itself to be an effective therapy for the m anagem entof ischem ic card iovascu lar diseases, However, considering that EECP significantly increases the acute diastolic pressure, whether it will intervene in the chronic progression of advanced plaque causing great concern in clilical applkation, but yet rein ains elusive presently. In the current paper, a flu id-structure interface （FSI） num erical model of artery with p iaque corn ponent w as developed based on in vivo hem odynam ic m easurem entperfotm ed h a porcine model, to caku late the m echanical stresses of the plaque before and during EECP, and h lum to assess the potential effects of long-term EECP treatm ent on plaque progression. The resu Its show that E E C P augm ented the wall shear stress （WSS） and plaque w all stress （PWS） over the card lac cycles, aswell as the spacial oscillatory of W SS （WSSG ）. Durhg EECP treatm ent, the PW S level respectively raised 6.82% and 6.07% in two simulation cases. The currentpilot study suggests that E E C P treatm entre ay p lay a positive effect on inh biting the conthued plaque progression by hcreashg the PW S level over the card iac cycles. Meanwhile, the plaque morphology should be taken into consideration while m aking patient- specific plan for Ion g- term E E C P treatment in clinic.

Enhance external counterpulsation(EECP) procedure has exhibited itself to be an effective therapy for the management of ischemic cardiovascular diseases.However,considering that EECP significantly increases the acute diastolic pressure,whether it will intervene in the chronic progression of advanced plaque causing great concern in clinical application,but yet remains elusive presently.In the current paper,a fluid-structure interface(FSI) numerical model of artery with plaque component was developed based on in vivo hemodynamic measurement performed in a porcine model,to calculate the mechanical stresses of the plaque before and during EECP,and in turn to assess the potential effects of long-term EECP treatment on plaque progression.The results show that EECP augmented the wall shear stress(WSS) and plaque wall stress(PWS) over the cardiac cycles,as well as the spacial oscillatory of WSS(WSSG).During EECP treatment,the PWS level respectively raised 6.82% and 6.07% in two simulation cases.The current pilot study suggests that EECP treatment may play a positive effect on inhibiting the continued plaque progression by increasing the PWS level over the cardiac cycles.Meanwhile,the plaque morphology should be taken into consideration while making patient-specific plan for long-term EECP treatment in clinic.