The possible role of intimal convective transport in atherogenesis

The possibility of fluid flux within the thickened subendothelial intima is considered. Both the media and the endothelium were already shown to be major hydraulic barriers. It is hypothesized that if the hydraulic conductivity of the inbetween layer of the subendothelial intima is considerably higher, then fluid flux in the downstream (axial) direction is likely to occur within the intima as a result of the luminal blood pressure wave. Macromolecular species (as lipoproteins) would then be transported axially by the fluid. This convective transport may give rise to the formation of early atheromas. The proposed mechanism is in accord with several clinical and experimental observations.