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Localization of atherosclerosis: role of hemodynamics
S G Frangos1, V Gahtan, B Sumpio
1Department of Surgery, Yale University School of Medicine, New Haven, Conn 06510, USA.
Insights
Atherosclerosis lesion development is not random, but influenced by mechanical forces on blood vessels. Understanding these hemodynamic forces on the endothelium is key to preventing atherosclerosis.
Area of Science:
- Cardiovascular Biology
- Biomedical Engineering
- Pathology
Background:
- Atherosclerosis is a systemic chronic disease.
- Lesion distribution in atherosclerosis is nonrandom, with specific arterial sites being more susceptible.
- Existing research points to systemic risk factors, but the precise localization mechanisms require further elucidation.
Purpose of the Study:
- To investigate the role of hemodynamic forces in the nonrandom localization of atherosclerotic lesions.
- To characterize the specific mechanical forces, such as shear stress and strain, acting on the vascular endothelium.
- To understand how these forces modify endothelial cells and contribute to atherogenesis.
Main Methods:
- Analysis of hemodynamic forces, including shear stress and cyclic circumferential strain.
- Investigation of the interaction between these forces and the active vascular endothelium.
- Examination of the modification of endothelial cell structure and function in response to mechanical stimuli.
Main Results:
- Hemodynamic forces, specifically shear stress and cyclic circumferential strain, are identified as key factors in the nonrandom distribution of atherosclerotic lesions.
- These mechanical forces actively modify endothelial cell structure and function.
- The characterized forces provide insight into the vascular propensity for developing atherosclerosis.
Conclusions:
- The localization of atherosclerotic lesions is significantly influenced by biomechanical forces, not solely systemic risk factors.
- Understanding the mechanobiology of the endothelium is crucial for comprehending atherogenesis.
- Targeting the interaction between hemodynamic forces and the endothelium may offer novel therapeutic strategies for atherosclerosis.
Abstract:
Atherosclerosis is a chronic disease attributed to risk factors that are systemic in nature. Yet the lesions involved do not occur in random fashion. The coronary arteries, the major branches of the aortic arch, and the abdominal aorta and its visceral and major lower extremity branches are particularly susceptible sites. Hemodynamic forces interacting with an active vascular endothelium are responsible for localizing lesions in a nonrandom pattern of distribution. Shear stress and cyclic circumferential strain are the predominant forces that have been characterized. The modification of endothelial cell structure and function by these mechanical forces sheds insight into the vasculature's propensity for atherogenesis.