Current Understanding of Atherogenesis - 18/04/17

Doi : 10.1016/j.amjmed.2016.10.022

Richard A. Brown, MBBS ^a, Eduard Shantsila, PhD ^a,^b, Chetan Varma, MD ^b, Gregory Y.H. Lip, MD ^a,^b,^⁎
^a Department of Medicine, University of Birmingham Institute of Cardiovascular Sciences, City Hospital, United Kingdom
^b Cardiology Department at Sandwell and West Birmingham Hospitals NHS Trust, City Hospital and Sandwell Hospital, West Bromwich, United Kingdom

^∗Requests for reprints should be addressed to Gregory Y.H. Lip, MD, University of Birmingham, Institute of Cardiovascular Sciences, City Hospital, Birmingham B187QH, United Kingdom.University of BirminghamInstitute of Cardiovascular SciencesCity HospitalBirminghamB187QHUnited Kingdom

Abstract

Scientific understanding of atherogenesis is constantly developing. From Virchow's observations 160 years ago we now recognize the endothelial response to injury as inflammatory, involved in all stages of atherosclerosis. Endothelial activation may cause reversible injury or dysfunction, or lead to irreparable damage. Indeed, early atherosclerosis is reversible. The introduction of genome-wide association testing has furthered the identification of potentially important genetic variants that help explain the heritability of coronary artery disease as well as spontaneous cases of severe coronary artery disease in patients with otherwise minimal risk factors. However, the mechanisms by which many of the newer variants exert their influence remain unknown.

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Keywords : Atherogenesis, Coronary artery disease, Genetic factors, Inflammation

Esquema

Normal Arterial Structure

Normal Endothelial Function

Endothelial Activation, Injury, and Dysfunction

The Impact of Conventional Modifiable and Nonmodifiable Cardiac Risk Factors on Endothelial Function in Patients with and without Coronary Artery Disease

Nonconventional Cardiac Risk Factors

Atherosclerotic Plaque Formation and Morphology

A Brief History

Response to Injury

Atherosclerotic Plaque Progression

Platelets

Genetic Regulators

Summary

	Funding: RAB was supported by a Rosetrees Medical Research Trust grant number M430.
	Conflict of Interest: None.
	Authorship: All authors had access to data used for manuscript preparation and a role in writing the manuscript.