The role of shear stress in the destabilization of vulnerable plaques and related therapeutic implications.

来自 NCBI

阅读量：

作者：

C Slager，J Wentzel，F Gijsen，A Thury，AC van，J Schaar，P Serruys

展开

摘要：

American Heart Association type IV plaques consist of a lipid core covered by a fibrous cap, and develop at locations of eccentric low shear stress. Vascular remodeling initially preserves the lumen diameter while maintaining the low shear stress conditions that encourage plaque growth. When these plaques eventually start to intrude into the lumen, the shear stress in the area surrounding the plaque changes substantially, increasing tensile stress at the plaque shoulders and exacerbating fissuring and thrombosis. Local biologic effects induced by high shear stress can destabilize the cap, particularly on its upstream side, and turn it into a rupture-prone, vulnerable plaque. Tensile stress is the ultimate mechanical factor that precipitates rupture and atherothrombotic complications. The shear-stress-oriented view of plaque rupture has important therapeutic implications. In this review, we discuss the varying mechanobiologic mechanisms in the areas surrounding the plaque that might explain the otherwise paradoxical observations and unexpected outcomes of experimental therapies.

展开

关键词：

atherosclerosis blood flow plaque rupture shear stress vulnerable plaque

DOI：

10.1038/ncpcardio0298

被引量：

509

年份：

2005