Mechanical factors in the initiation and fate of atherosclerotic plaques

Peter D Weinberg

Department of Bioengineering

Imperial College London

J R A Mitchell, C J Schwartz. Arterial Disease, 1965

Flo

w

J R A Mitchell, C J Schwartz. Arterial Disease, 1965

CG Caro et al, Proc R Soc Lond B 1971;177:109-159

Flo

w

N Anitschkow. In: Arteriosclerosis (E V Cowdry, ed), 1933.

Nicolai Anitschkow (1885-1964)

Flo

w

J B Somer, C J Schwartz. Atherosclerosis 1971;13:293-304.

Flo

w

There is a continuous movement of plasma constituents from lumen to adventitia

“Lipoids” in this flow precipitate by interaction with the ground substance of the wall

Lymphocytes or monocytes enter the wall and ingest lipoid, becoming foam cells

Process occurs faster where there is a greater transport across the wall

Insudation theory of Anitschkow

N Anitschkow. In: Arteriosclerosis (E V Cowdry, ed), 1933.

S E Barnes, P D Weinberg. Arterioscler Thromb Vasc Biol 1998;18:300-308

Flo

w

S E Barnes, P D Weinberg. Arterioscler Thromb Vasc Biol 1999;19:2376-2386.

Flo

w

Immature Mature

A Sebkhi, P D Weinberg. Atherosclerosis 1994;106:1-8.

H Sinzinger et al. Blood Vessels 1980; 17: 44-52

R C Schroter, unpublished

P D Weinberg Biorheology 2002;39:533-537 Pictures from R C Schroter, G D Sloop, J R A Mitchell & C J Schwartz

Flo

w

A Sebkhi, P D Weinberg. Arterioscler Thromb Vasc Biol 1996;16:317-327.

B A Forster, P D Weinberg. Arterioscler Thromb Vasc Biol 1997;17:1361-1368.

0

2

4

6

8

10

12

14

16

18

Downstream Upstream

Per

mea

bili

ty (

cm/s

x 1

0^8)

Control

Coarctation

C L Murphy and M J Lever

T J Staughton, M J Lever, P D Weinberg. Am J Physiol 2001;281:H53-H59.

( D

owns

trea

m -

ups

trea

m /

mea

n )

x 10

0%

Al-Musawi, Bishton, Dean, Williams, Cremers, Weinberg. Atherosclerosis 2004;72:79

0.9

1

1.1

1.2

L:W

ups

trea

m /

L:W

dow

nstr

eam

.

young mature

*

0.2 mm

A Kazakidi, S J Sherwin, P D Weinberg, unpublished data

Roach MR, Fletcher J. Atherosclerosis. 1976;24:327-33.

control

cuff

Flo

w

Thubrikar MJ, Baker JW, Nolan SP. Arteriosclerosis. 1988;8:410-20.

control

control

cuff

Cheng, C. et al. Circulation 2006;113:2744-2753