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[Atherosclerosis and brain circulation]
R M Sánchez-Pérez1, J M Moltó, V Medrano
1Servicio de Neurología, Hospital General Universitario de Alicante, España.
Insights
Atherosclerosis, a diffuse vascular disease, underlies major cardiovascular and cerebrovascular conditions. Understanding its plaque growth and cellular mechanisms is key to developing new treatments.
Area of Science:
- Vascular Biology
- Pathophysiology
- Neurology
Context:
- Atherosclerosis is a widespread vascular condition linked to prevalent cardiovascular and cerebrovascular diseases.
- Understanding its pathogenic mechanisms is crucial for developing effective treatments and preventive strategies.
Purpose:
- To review the concept of atherosclerosis, plaque development, and its cellular mechanisms.
- To analyze the influence of atherosclerosis on brain hemodynamics and cerebrovascular ischemic disease.
- To highlight differences in atherosclerosis across vascular territories and resulting clinical syndromes.
Summary:
- This review covers atherosclerosis, atheromatous plaque growth, and cellular mechanisms.
- It examines the impact on brain hemodynamics and cerebrovascular ischemic disease, noting variations across different vascular structures.
- Ischemic cerebrovascular disease encompasses heterogeneous syndromes with distinct etiopathogenic mechanisms (cardioembolic, atherothrombotic, hemodynamic).
Impact:
- Distinguishing between different etiologies of ischemic brain infarctions is essential for accurate clinical trial interpretation.
- Recognizing the heterogeneity of ischemic cerebrovascular disease can resolve discrepancies in research findings.
- This knowledge aids in the development of targeted therapies for atherosclerosis-related conditions.
Introduction:
Atherosclerosis affects the vascular system in a diffuse way and its is clearly implicated in some of the most prevalent diseases in western countries such as cerebrovascular and cardiovascular diseases. Knowing more about the underlying pathogenic mechanisms may contribute to a better understanding of this entities and the development of therapies for both its treatment and prevention.
Development:
We review herein the concepts included in the term atherosclerosis, the growth of the atheromatous plaque and its complications and the cellular mechanisms which intervene in its development. We analyze how it influences brain hemodynamics and its implication in cerebrovascular ischemic disease paying attention to the dissimilarities with other vascular territories and the clinical syndromes which derive from its development on different vascular structures.
Conclusions:
Under the concept of ischemic cerebrovascular disease we can find a group of heterogeneous clinical syndromes, usually associated to different etiopathogenic mechanisms: cardioembolic, atherothrombotic or hemodynamic. Although their risk factors may be common, these processes are clearly different form each other. Therefore including ischemic brain infarctions all together without attending to their etiology may produce important methodological biases when interpreting the results in clinical trials or other studies, and may also be a suitable explanation for differences between authors.