TY - JOUR
T1 - Atherosclerotic plaques
T2 - is endothelial shear stress the only factor?
AU - Anssari-Benam, Afshin
AU - Korakianitis, Theodosios
N1 - NOTICE: this is the author’s version of a work that was accepted for publication in 'Medical hypotheses'. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in 'Medical hypotheses, VOL. 81, ISSUE 2, (2013), DOI: 10.1016/j.mehy.2013.04.041
PY - 2013/8
Y1 - 2013/8
N2 - Initiation and development of atherosclerosis has largely been attributed to irregular shear stress patterns
and values, in the current literature. Abnormalities such as low shear stress, reversing and oscillatory
shear force patterns, as well as temporal variations of shear stress are the most cited factors.
However, clinical findings have further indicated that plaques have still been formed and developed in
arterial sites that possess relatively more steady and higher shear stresses than those observed in studies
correlating low or oscillatory shear stresses with atherosclerosis. These data imply that deviations in
shear stress from its normal physiological pattern alone may not be the only factor inducing atherosclerosis,
and additional haemodynamics parameter other then shear stress may also contribute to the initiation
and development of plaques. In this paper, we hypothesise that the combined effect of wall shear
stress and circumferential stress waves, in the form of angular phase difference between the two waves at
each cardiac cycle, may be a more accurate determinant of plaque formation and growth. Furthermore,
arterial sites that possess more positive values of this angular phase difference may be more prone to plaque
formation or development. If proved correct, this theory can transform our understanding of endothelial
cell mechanotransduction and mechanobiology, and may lead to design and utilisation of new
diagnostic procedures and equipment as predictive and preventive clinical tools for patients with abnormal
arterial blood pressure.
AB - Initiation and development of atherosclerosis has largely been attributed to irregular shear stress patterns
and values, in the current literature. Abnormalities such as low shear stress, reversing and oscillatory
shear force patterns, as well as temporal variations of shear stress are the most cited factors.
However, clinical findings have further indicated that plaques have still been formed and developed in
arterial sites that possess relatively more steady and higher shear stresses than those observed in studies
correlating low or oscillatory shear stresses with atherosclerosis. These data imply that deviations in
shear stress from its normal physiological pattern alone may not be the only factor inducing atherosclerosis,
and additional haemodynamics parameter other then shear stress may also contribute to the initiation
and development of plaques. In this paper, we hypothesise that the combined effect of wall shear
stress and circumferential stress waves, in the form of angular phase difference between the two waves at
each cardiac cycle, may be a more accurate determinant of plaque formation and growth. Furthermore,
arterial sites that possess more positive values of this angular phase difference may be more prone to plaque
formation or development. If proved correct, this theory can transform our understanding of endothelial
cell mechanotransduction and mechanobiology, and may lead to design and utilisation of new
diagnostic procedures and equipment as predictive and preventive clinical tools for patients with abnormal
arterial blood pressure.
U2 - 10.1016/j.mehy.2013.04.041
DO - 10.1016/j.mehy.2013.04.041
M3 - Article
SN - 0306-9877
VL - 81
SP - 235
EP - 239
JO - Medical Hypotheses
JF - Medical Hypotheses
IS - 2
ER -