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2014 ; 35
(43
): 3013-20, 3020a-3020d
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Biomechanical factors in atherosclerosis: mechanisms and clinical implications
#MMPMID25230814
Kwak BR
; Bäck M
; Bochaton-Piallat ML
; Caligiuri G
; Daemen MJ
; Davies PF
; Hoefer IE
; Holvoet P
; Jo H
; Krams R
; Lehoux S
; Monaco C
; Steffens S
; Virmani R
; Weber C
; Wentzel JJ
; Evans PC
Eur Heart J
2014[Nov]; 35
(43
): 3013-20, 3020a-3020d
PMID25230814
show ga
Blood vessels are exposed to multiple mechanical forces that are exerted on the
vessel wall (radial, circumferential and longitudinal forces) or on the
endothelial surface (shear stress). The stresses and strains experienced by
arteries influence the initiation of atherosclerotic lesions, which develop at
regions of arteries that are exposed to complex blood flow. In addition, plaque
progression and eventually plaque rupture is influenced by a complex interaction
between biological and mechanical factors-mechanical forces regulate the cellular
and molecular composition of plaques and, conversely, the composition of plaques
determines their ability to withstand mechanical load. A deeper understanding of
these interactions is essential for designing new therapeutic strategies to
prevent lesion development and promote plaque stabilization. Moreover,
integrating clinical imaging techniques with finite element modelling techniques
allows for detailed examination of local morphological and biomechanical
characteristics of atherosclerotic lesions that may be of help in prediction of
future events. In this ESC Position Paper on biomechanical factors in
atherosclerosis, we summarize the current 'state of the art' on the interface
between mechanical forces and atherosclerotic plaque biology and identify
potential clinical applications and key questions for future research.