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. 2024 Feb 8;119(2):193–213. doi: 10.1007/s00395-024-01033-5

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Graphical representation of a vulnerable plaque and cap with its most important mechanical stressors, cap components, and their influence on tissue mechanics. A A simplified graphical representation of a longitudinal section of an atherosclerotic plaque with the primary forces acting on it. B Zoom-in of the cap region with the primary stressors locally initiating tissue stress. C Graphic of a transverse section of a vulnerable plaque with a fibrous cap, showing the shoulder (i) and mid-cap (ii) regions. D The cap compositional characteristics which influence tissue mechanics, being collagen, macrophages, and microcalcifications, and their effect through various individual characteristics on cap mechanics and consequent cap rupture.

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