Atherosclerotic plaque rupture: a fatigue process?

The mechanism of atherosclerotic: plaque rupture is not known. Current theo ries focus on the acute triggers of plaque rupture and myocardial infarctio n such as increased shear or circumferential stress, rupture of the vasa va sorum and vasospasm. We hypothesize that a critical mechanism causing plaqu e rupture is fatigue failure, the catastrophic rupture of a material follow ing exposure to high-cycle, low-amplitude repetitive stress.. Comparisons b etween material fatigue and plaque rupture demonstrate that this hypothesis is consistent with known physiologic and epidemiologic data on plaque rupt ure. (C) 2000 Harcourt Publishers Ltd.