Exploring the relationship between biomechanical stresses and coronary atherosclerosis

James N. Cameron, Ojas H. Mehta, Michael Michail, Jasmine Chan, Stephen J. Nicholls, Martin R. Bennett, Adam J. Brown

Research output: Contribution to journalReview ArticleResearchpeer-review

24 Citations (Scopus)


The pathophysiology of coronary atherosclerosis is multifaceted. Plaque initiation and progression are governed by a complex interplay between genetic and environmental factors acting through processes such as lipid accumulation, altered haemodynamics and inflammation. There is increasing recognition that biomechanical stresses play an important role in atherogenesis, and integration of these metrics with clinical imaging has potential to significantly improve cardiovascular risk prediction. In this review, we present the calculation of coronary biomechanical stresses from first principles and computational methods, including endothelial shear stress (ESS), plaque structural stress (PSS) and axial plaque stress (APS). We discuss the current experimental and human data linking these stresses to the natural history of coronary artery disease and explore the future potential for refining treatment options and predicting future ischaemic events.

Original languageEnglish
Pages (from-to)43-51
Number of pages9
Publication statusPublished - Jun 2020


  • Atherosclerosis
  • Axial plaque stress
  • Computational modelling
  • Coronary artery disease
  • Endothelial shear stress
  • Plaque rupture
  • Plaque structural stress

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