Oxidative Stress and Vascular Remodeling View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

1997

AUTHORS

Bradford C. Berk

ABSTRACT

It has become clear that vascular remodeling is an important pathophysiologic component in several cardiovascular diseases including atherosclerosis, restenosis after percutaneous transluminal coronary angioplasty (PTCA) and hypertension. Glagov (1) was one of the first to demonstrate that the atherosclerotic vessel attempted to “accommodate” increasing plaque burden by enlarging vessel diameter based on studies of patient necropsy samples. Recently, intravascular ultrasound (IVUS) has shown that remodeling is frequent in both angiographically normal vessels and those with clear evidence of atherosclerosis (2). Of great interest, remodeling is dynamic as shown by the vessel response following PICA (3, 4), a process that appears to be highly variable among individuals. Following PTCA, restenosis (lumen diameter <50%) develops in 30–40% of patients. For many years restenosis was thought to be caused by luminal encroachment due to smooth muscle cell migration and proliferation. However, the IVUS studies of Leon and colleagues show that lumen narrowing is caused to a greater extent by changes in remodeling (~66%) than by changes in neointima mass (~34%)(3, 4). These changes may be characterized simplistically as whether the vessel “scars down” or “expands out”. Importantly, to date there is no correlation with the nature of the remodeling response and traditional cardiovascular risk factors except diabetes. The heterogeneous nature of remodeling in both atherosclerosis and post-PTCA situations suggests that multiple genetic, systemic, and vessel wall events determine the final outcome. More... »

PAGES

277-304

Book

TITLE

Arterial Remodeling: A Critical Factor in Restenosis

ISBN

978-1-4613-7785-6
978-1-4615-6079-1

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-1-4615-6079-1_14

DOI

http://dx.doi.org/10.1007/978-1-4615-6079-1_14

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1036966664


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