TY - JOUR
T1 - In-vivo assessment of the natural history of coronary atherosclerosis
T2 - Vascular remodeling and endothelial shear stress determine the complexity of atherosclerotic disease progression
AU - Papafaklis, Michail I.
AU - Koskinas, Konstantinos C.
AU - Chatzizisis, Yiannis S.
AU - Stone, Peter H.
AU - Feldman, Charles L.
PY - 2010/11
Y1 - 2010/11
N2 - PURPOSE OF REVIEW: Atherosclerotic disease progression is determined by localized plaque growth, which is induced by systemic and local hemodynamic factors, and the nature of the wall remodeling response. The purpose of this review is to summarize the processes underlying the heterogeneity of coronary atherosclerosis progression in relation to the local hemodynamic and arterial remodeling environment. RECENT FINDINGS: Multiple competing biological processes in the extracellular matrix define the extent of vascular remodeling and disease progression. The remodeling phenomenon is not consistent but is characterized by great phenotypical heterogeneity which reflects the complex effect of systemic, genetic and hemodynamic factors on the arterial wall response to plaque formation and progression. The exaggeration of expansive remodeling (i.e., excessive expansive remodeling) likely contributes to the transformation of an initially favorable action into an excessive course of vessel expansion, continued disease progression and plaque instability. Extremely low endothelial shear stress and excessive expansive remodeling establish a vicious cycle which leads to the formation of severe plaques with high-risk characteristics. SUMMARY: The dynamic interplay between the local hemodynamic environment and the wall remodeling behavior determines the complexity of the natural history of atherosclerosis and explains the development of localized plaque vulnerability.
AB - PURPOSE OF REVIEW: Atherosclerotic disease progression is determined by localized plaque growth, which is induced by systemic and local hemodynamic factors, and the nature of the wall remodeling response. The purpose of this review is to summarize the processes underlying the heterogeneity of coronary atherosclerosis progression in relation to the local hemodynamic and arterial remodeling environment. RECENT FINDINGS: Multiple competing biological processes in the extracellular matrix define the extent of vascular remodeling and disease progression. The remodeling phenomenon is not consistent but is characterized by great phenotypical heterogeneity which reflects the complex effect of systemic, genetic and hemodynamic factors on the arterial wall response to plaque formation and progression. The exaggeration of expansive remodeling (i.e., excessive expansive remodeling) likely contributes to the transformation of an initially favorable action into an excessive course of vessel expansion, continued disease progression and plaque instability. Extremely low endothelial shear stress and excessive expansive remodeling establish a vicious cycle which leads to the formation of severe plaques with high-risk characteristics. SUMMARY: The dynamic interplay between the local hemodynamic environment and the wall remodeling behavior determines the complexity of the natural history of atherosclerosis and explains the development of localized plaque vulnerability.
KW - atherosclerosis
KW - extracellular matrix
KW - imaging modalities
KW - remodeling
KW - shear stress
UR - http://www.scopus.com/inward/record.url?scp=78049265832&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78049265832&partnerID=8YFLogxK
U2 - 10.1097/HCO.0b013e32833f0236
DO - 10.1097/HCO.0b013e32833f0236
M3 - Review article
C2 - 20838338
AN - SCOPUS:78049265832
VL - 25
SP - 627
EP - 638
JO - Current Opinion in Cardiology
JF - Current Opinion in Cardiology
SN - 0268-4705
IS - 6
ER -