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Vascular failure: a hypothesis
Stephen M Schwartz1, Randolph L Geary, Lawrence D Adams
1Department of Pathology, I-420 HSB, University of Washington School of Medicine, Seattle, WA 98195-7335, USA. schwartzs@u.washington.edu
Insights
Vascular failure, unlike cardiac failure, is not well-defined. This study proposes that arterial failure, involving vessel mass and function, shares pathways with cardiac failure, leading to conditions like hypertension and atherosclerosis.
Area of Science:
- Cardiovascular Science
- Vascular Biology
- Pathophysiology
Background:
- Cardiac failure is extensively studied, but vascular failure lacks a clear definition.
- Vascular failure, particularly arterial failure, has significant but distinct consequences compared to cardiac failure.
- Understanding normal vascular remodeling is crucial for identifying failure mechanisms.
Purpose of the Study:
- To propose 'arterial failure' as a recognizable term.
- To explore the parallels between cardiac and vascular failure pathways.
- To investigate the consequences of impaired vascular remodeling, such as hypertension and atherosclerosis.
Main Methods:
- Literature review of normal vascular remodeling.
- Comparative analysis of pathways involved in cardiac and vascular failure.
- Conceptual framework development for arterial failure.
Main Results:
- Arterial failure involves the vessel's inability to control mass, contractile capacity, and lumen.
- Failure in mass and diameter control can lead to hypertension and atherosclerosis.
- Pathways similar to cardiac failure may be involved in arterial dysfunction.
Conclusions:
- Arterial failure is a critical concept that warrants further research.
- Understanding vascular remodeling failure is key to addressing hypertension and atherosclerosis.
- Further research should focus on the molecular and cellular mechanisms underlying arterial failure.
Abstract:
Although cardiac failure has been studied extensively, vascular failure is not a recognizable term. We suggest that it is reasonable to argue that failure of the vessel to control its mass, contractile capacity, and lumen will involve pathways similar to cardiac failure. Vascular failure, or perhaps more accurately arterial failure, has very different consequences. Failure to control mass and external diameter will result in hypertension or loss of lumen in atherosclerosis. We review what is known about this normal remodeling response and its failure, and propose directions for research.