Mechanics of Atherosclerosis 2025

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As plaque builds up, your artery wall grows thicker and harder. This hardening of the arteries is usually a silent process in the early stages. You may not notice symptoms for a long time. But eventually, as the plaque grows, the opening (lumen) of your artery narrows, leaving less room for blood to flow.
Atherosclerosis is a lipoprotein-driven disease that leads to plaque formation at specific sites of the arterial tree through intimal inflammation, necrosis, fibrosis, and calcification.
The basic mechanisms of atherosclerosis involve lipid accumulation and immune activation in the vascular wall (see Fig. 4.1).
Atherosclerosis is initiated by endothelium activation and, followed by a cascade of events (accumulation of lipids, fibrous elements, and calcification), triggers the vessel narrowing and activation of inflammatory pathways.
Atherosclerosis is associated with inflammatory processes in the endothelial cells of the vessel wall associated with retained low-density lipoprotein (LDL) particles. This retention may be a cause, an effect, or both, of the underlying inflammatory process.
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Atherosclerosis is a chronic inflammatory disease in which there is a build up of plaques inside arteries. These plaques are principally composed of lipids that induce an inflammatory reaction causing turbulent flow with atheroscl cardiovascular disease (ASCVD) as a result.

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