Hæmodynamic Aspects of Atherogenesis

Abstract

ATHEROSCLEROSIS is generally regarded as a disease process which is mainly due to disorder of metabolic factors such as lipoproteins, hormones, heparin, etc. These factors have been extensively studied, especially with respect to lipoproteins. However, careful examination of the artery at autopsy shows that plaques are scattered all along an arterial branch. An artery of considerable length uniformly and concentrically coated with lipid material without localized regions of sclerosis seems to be quite rare. On the contrary, plaques are in the majority of the cases deposited in a peculiar pattern. Such deposition of lipid materials and the topographical arrangement of plaques cannot be explained readily by general metabolic factors alone. Thus a method of quantitative grading of atherosclerosis has been developed¹ in order to distinguish the role of the general metabolic factors and local factors. This technique has been applied to a study of the interrelationship between cerebral and coronary atherosclerosis². By quantitative grading of sclerosis and systematic analysis of the coronary artery for relative position and severity of plaques one is able to demonstrate the significance of local factors in atherogenesis.