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Related Concept Videos

Atherosclerosis I: Introduction01:30

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Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Updated: Jan 15, 2026

A Method to Study the Correlation Between Local Collagen Structure and Mechanical Properties of Atherosclerotic Plaque Fibrous Tissue
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Endothelial dysfunction in plaque rupture and plaque erosion.

Yuki Ishii1, Motoki Kure1, Hiroshi Kawasumi1

  • 1Department of Cardiology, Showa Medical University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan.

Heart and Vessels
|October 6, 2025
PubMed
Summary

Vascular endothelial function, measured by flow-mediated dilation (FMD), was similarly impaired in acute coronary syndrome (ACS) patients with plaque erosion (PE) and plaque rupture (PR). However, FMD levels impacted major adverse cardiac events (MACE) differently based on the culprit lesion type.

Keywords:
Endothelial functionFMDOptical frequency domain imagingPlaque erosionPlaque rupture

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Area of Science:

  • Cardiology
  • Vascular Biology
  • Medical Imaging

Background:

  • Vascular endothelial dysfunction is central to acute coronary syndrome (ACS) pathophysiology.
  • Plaque erosion (PE) and plaque rupture (PR) are primary ACS mechanisms, but their differential impact on endothelial function remains unclear.
  • Flow-mediated dilation (FMD) quantifies endothelial function.

Purpose of the Study:

  • To compare endothelial function, assessed by FMD, between patients with PE and PR.
  • To investigate the prognostic significance of FMD in relation to culprit lesion type in ACS.

Main Methods:

  • Retrospective analysis of 160 ACS patients undergoing primary percutaneous coronary intervention (PCI).
  • Optical frequency domain imaging (OFDI) categorized culprit plaques as PE or PR.
  • FMD assessment was performed, and patients were stratified into high-FMD (>4.1%) and low-FMD (≤4.1%) groups.
  • Clinical characteristics and major adverse cardiac events (MACE) were compared across four groups: PR-HighFMD, PR-LowFMD, PE-HighFMD, and PE-LowFMD.

Main Results:

  • Endothelial function was similarly impaired in PE and PR groups (FMD 4.2% vs. 4.1%, P=0.85).
  • The PR-HighFMD group exhibited the highest MACE-free survival.
  • The PR-LowFMD group had the highest risk of MACE (HR=5.44, P=0.008), followed by PE-HighFMD and PE-LowFMD groups.

Conclusions:

  • FMD is impaired in both PE and PR-related ACS.
  • FMD has a prognostic impact on MACE in ACS patients, potentially varying with the type of culprit lesion.
  • Further research is warranted to elucidate the prognostic role of endothelial function in different ACS etiologies.