Thin-capped atheromata with reduced collagen content in pigs develop in coronary arterial regions exposed to persistently low endothelial shear stress

  • Koskinas K
  • Sukhova G
  • Baker A
 et al. 
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OBJECTIVE The mechanisms promoting the focal formation of rupture-prone coronary plaques in vivo remain incompletely understood. This study tested the hypothesis that coronary regions exposed to low endothelial shear stress (ESS) favor subsequent development of collagen-poor, thin-capped plaques. APPROACH AND RESULTS Coronary angiography and 3-vessel intravascular ultrasound were serially performed at 5 consecutive time points in vivo in 5 diabetic, hypercholesterolemic pigs. ESS was calculated along the course of each artery with computational fluid dynamics at all 5 time points. At follow-up, 184 arterial segments with previously identified in vivo ESS underwent histopathologic analysis. Compared with other plaque types, eccentric thin-capped atheromata developed more in segments that experienced lower ESS during their evolution. Compared with lesions with higher preceding ESS, segments persistently exposed to low ESS (

Author-supplied keywords

  • Atherosclerosis
  • Collagen
  • Endothelial shear stress
  • Metalloproteinases
  • Natural history

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  • Michail PapafaklisSaint Bartholomew's Hospital

  • Konstantinos C. Koskinas

  • Galina K. Sukhova

  • Aaron B. Baker

  • Yiannis S. Chatzizisis

  • Ahmet U. Coskun

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