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Patrick updown


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SHAPE Society

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Patrick updown

  1. 1. Plaque rupture proximal of minimal lumen  Coronary artery Fujii, et al. Circulation 2003  Carotid artery Lovett and Rothwell, Cerebrovasc Dis 2003 Dirksen et al., Circulation 1998 Masawa, Pathology International 1994  Reason(s)?  Direct mechanical effect of shear stress Gertz and Roberts, Editorial Am J Card, 1990  Biological effect of shear stress on cap stability Hemodynamics Laboratory Thoraxcenter Rotterdam Slager et al., Nat Clin Pract Card 2005
  2. 2. Biological observations related to flow direction Dirksen et al., Circ. 1998 Flow High density Low density High densityLow density Tricot et al., Circ. 2000 Macrophages Flow Smooth muscle cells 2.7% 18.8 % Endothelial cells in apoptosis Flow Hemodynamics Laboratory Thoraxcenter Rotterdam
  3. 3. Shear stress distribution over advanced plaque High shear stress Cap Blood flow Lipid core Low shear stress Hemodynamics Laboratory Thoraxcenter Rotterdam
  4. 4. Spatially restricted endothelial anti-inflammatory signaling Slager et al., Nat Clin Pract Card 2005 Hemodynamics Laboratory Thoraxcenter Rotterdam
  5. 5. Low Shear Stress
  6. 6. Cap weakening due to High Shear Stress
  7. 7. Cap weakening due to High Shear Stress