Atherosclerosis: a bioengineer’s perspective 2/24/10
Dec 31, 2015
Cardiovascular disease (CVD)
• #1 cause of death in the United States• In 2006, claimed more lives than cancer, car
accidents, and HIV (AIDS) combined• About 25% of Americans have some form of CVD• 100% of people exhibit vessel stiffening which
correlates with risk of CVD americanheart.org
foodnetwork.com med.cornell.edu
Detection?
• Atherosclerosis is typically asymptomatic!
• It is most often found after it manifests itself as a heart attack or stroke
• Measure of LDL within the blood as a predictor
• 20% of events occur in individuals with no major risk factors
Endothelial cell Monocyte Macrophage Foam cell Smooth muscle cell
Internal elastic lamina
Vessel lumen
1. Endothelial permeability
4. SMC migration2. Monocyte
adhesion and transmigration
Increased stiffness
3. Macrophage transformation into foam cells
The major cellular events in the progression of atherosclerosis
Histology of a normal artery
http://www.siumed.edu/~dking2/crr/cvguide.htm
The medial layer contributes most to the mechanical strength of an artery
Hemodynamics within arterial lesions: A longstanding bioengineering problem
Malek AM et al (1999)
Flow pattern Arteriogram of a stroke patient Velocity map of flow
Young’s modulus of soft tissues
Modified from Levental, et al. Soft Matter 2007
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Endothelial cell Monocyte Macrophage Foam cell Smooth muscle cell
Internal elastic lamina
Vessel lumen
1. Endothelial permeability
4. SMC migration2. Monocyte
adhesion and transmigration
Increased stiffness
3. Macrophage transformation into foam cells
The major cellular events in the progression of atherosclerosis