Compensatory enlargement of atherosclerotic vessels — An analysis through morphoelasticity

In 1987 Seymour Glagov published a key result on how atherosclerotic arteries remodel. His post-mortem data on human coronary arteries suggested that over the course of atherosclerotic disease, the vessel wall expands, keeping the lumen area approximately constant before before luminal encroachment occurs. This “compensatory” enlargement has been confirmed in-vivo and in other organisms. However, this behavior has never been explained physically.

We propose a three-layer morphoelastic model to describe arterial remodeling. Each layer is described as a collagen-fiber reinforced anisotropic composite. Growth occurs in the intima only. This simple biomechanics model is able to reproduce the main features of the data. We discuss a methodology using finite elements and provide a physically appealing explanation of Glagovian remodeling.