Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
25
pubmed:dateCreated
2007-6-29
pubmed:abstractText
Although the entire coronary tree is exposed to the atherogenic effect of the systemic risk factors, atherosclerotic lesions form at specific arterial regions, where low and oscillatory endothelial shear stress (ESS) occur. Low ESS modulates endothelial gene expression through complex mechanoreception and mechanotransduction processes, inducing an atherogenic endothelial phenotype and formation of an early atherosclerotic plaque. Each early plaque exhibits an individual natural history of progression, regression, or stabilization, which is dependent not only on the formation and progression of atherosclerosis but also on the vascular remodeling response. Although the pathophysiologic mechanisms involved in the remodeling of the atherosclerotic wall are incompletely understood, the dynamic interplay between local hemodynamic milieu, low ESS in particular, and the biology of the wall is likely to be important. In this review, we explore the molecular, cellular, and vascular processes supporting the role of low ESS in the natural history of coronary atherosclerosis and vascular remodeling and indicate likely mechanisms concerning the different natural history trajectories of individual coronary lesions. Atherosclerotic plaques associated with excessive expansive remodeling evolve to high-risk plaques, because low ESS conditions persist, thereby promoting continued local lipid accumulation, inflammation, oxidative stress, matrix breakdown, and eventually further plaque progression and excessive expansive remodeling. An enhanced understanding of the pathobiologic processes responsible for atherosclerosis and vascular remodeling might allow for early identification of a high-risk coronary plaque and thereby provide a rationale for innovative diagnostic and/or therapeutic strategies for the management of coronary patients and prevention of acute coronary syndromes.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1558-3597
pubmed:author
pubmed:issnType
Electronic
pubmed:day
26
pubmed:volume
49
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2379-93
pubmed:dateRevised
2008-1-7
pubmed:meshHeading
pubmed-meshheading:17599600-Blood Flow Velocity, pubmed-meshheading:17599600-Coronary Artery Disease, pubmed-meshheading:17599600-Coronary Circulation, pubmed-meshheading:17599600-Coronary Vessels, pubmed-meshheading:17599600-Disease Progression, pubmed-meshheading:17599600-Endothelium, Vascular, pubmed-meshheading:17599600-Female, pubmed-meshheading:17599600-Humans, pubmed-meshheading:17599600-Male, pubmed-meshheading:17599600-Mechanoreceptors, pubmed-meshheading:17599600-Nitric Oxide, pubmed-meshheading:17599600-Nitric Oxide Synthase Type III, pubmed-meshheading:17599600-Oxidative Stress, pubmed-meshheading:17599600-Regeneration, pubmed-meshheading:17599600-Risk Assessment, pubmed-meshheading:17599600-Sensitivity and Specificity, pubmed-meshheading:17599600-Stress, Mechanical, pubmed-meshheading:17599600-Ultrasonography, Interventional, pubmed-meshheading:17599600-Vascular Resistance
pubmed:year
2007
pubmed:articleTitle
Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior.
pubmed:affiliation
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
pubmed:publicationType
Journal Article, Review