Necrotic Core in Advanced Atherosclerotic Plaques in Human Coronaries Is Exposed to Elavated Shear Stress

In early atherosclerosis, plaques localize in low shear stress regions. During plaque development, the lumen of the artery remains patent due to vascular remodeling and unfavorable low shear stress conditions can persist. Consequently, a continuous influx of lipids can be anticipated in these regions, possibly leading to the development vulnerable plaques. If the plaque exceeds a certain size, vascular remodeling will not be able to maintain the lumen dimensions and the plaque will cause lumen narrowing. This is generally accompanied by shear stress increase in certain regions of the plaque. Evidence is accumulating that increased levels of shear stress influences plaque composition in such a way that it might induce plaque destabilization and ulcer formation.

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Plaque and Shear Stress Distribution in Human Coronary Bifurcations: a Multi-Slice Computed Tomography Study

ASME 2007 Summer Bioengineering Conference ◽

10.1115/sbc2007-176309 ◽

2007 ◽

Cited By ~ 1

Author(s):

Alina G. van der Giessen ◽

Jolanda J. Wentzel ◽

Frans N. van de Vosse ◽

Antonius F. van der Steen ◽

Pim J. de Feyter ◽

...

Keyword(s):

Computed Tomography ◽

Shear Stress ◽

Outer Wall ◽

Atherosclerotic Plaques ◽

Advanced Stage ◽

Flow Divider ◽

Low Shear Stress ◽

Curved Vessels ◽

Early Atherosclerosis ◽

Low Shear

It is generally accepted that early atherosclerosis develops in low shear-stress (SS) regions such as the outer wall of arterial bifurcations and the inner bend of curved vessels (1). However, in clinical practice, it is common to observe atherosclerotic plaques at the flow-divider, or carina, of coronary bifurcations (2). Plaques at the carina are more frequently found in symptomatic patients, and may represent a more advanced stage of atherosclerosis. The carina is located in a region which is exposed to high SS. We hypothesize that if plaques are located in atheroprotective high SS regions, they have grown circumferentially from the atherogenic low SS regions.

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Shear Stress Modulates Plaque Composition in Human Coronary Arteries In Vivo

ASME 2008 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2008-192764 ◽

2008 ◽

Author(s):

Frank Gijsen ◽

Jolanda Wentzel ◽

Johan Schuurbiers ◽

Frits Mastik ◽

Johannes Schaar ◽

...

Keyword(s):

Shear Stress ◽

Atherosclerotic Plaques ◽

Plaque Composition ◽

Low Shear Stress ◽

Advanced Stages ◽

Shear Stress And Strain ◽

Stress Influences ◽

The Relationship ◽

Low Shear

It is well established that atherosclerotic plaques generally develop in low shear stress regions, including curved arterial segments and bifurcations1. Once these plaques intrude into the lumen, the shear stress they are exposed to alters with hitherto unknown consequences. We hypothesize that in the more advanced stages of the disease, shear stress has an important impact on plaque composition in such a way that high shear stress enhances plaque vulnerability through its biological impact on the endothelium2. We investigated this hypothesis previously by studying the relationship between shear stress and strain, a marker for plaque composition, in human coronary arteries3. In this study, we will extend that study by investigating how shear stress influences changes of strain, and thus plaque composition, over a period of 6 months.

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