This is followed by the accumulation of a mixed leukocyte population within the subendothelial space.6 The earliest macroscopically recognizable atherosclerotic lesions are fatty streaks. Lipid-laden monocytes, macrophages (foam cells), and T lymphocytes are known to be the essential components of fatty streaks.6 Progression to intermediate and then advanced lesions is characterized by the formation of a selleck products fibrous cap overlying a lipid-rich core. The fibrous cap is known to be a balance between the smooth muscle cells producing collagen and the Inhibitors,research,lifescience,medical macrophages degrading collagen. The thickness of the cap depends on the relative activity of those two components and there
is, therefore, a danger of the fibrous cap rupturing, which may lead to acute fatal cardiovascular events.7 Thrombosis occurs as a consequence of a ruptured fibrous Inhibitors,research,lifescience,medical cap, and this catastrophic phenomenon is very frequent at the inflamed and thinned sites of the fibrous cap in advanced lesions. Thinning of the fibrous cap is apparently due to the continuing influx and activation of macrophages which release matrix metalloproteinases (MMPs) and other proteolytic enzymes at these sites. These enzymes cause the degradation of the matrix and can bring about thrombus formation and subsequent Inhibitors,research,lifescience,medical occlusion of the artery.6 Atherosclerosis Velocity One important
aspect of atherogenesis that we believe has not received due attention is the rate at which atherosclerosis Inhibitors,research,lifescience,medical develops. Most previous work has focused on the development and progression of atherosclerosis, but the rate of progression has been largely ignored. For example, if we ask which risk factors or a combination of which risk factors are important for the rate of atherosclerosis development, it is unclear what they may be, although accelerated atherosclerosis has been described following angioplasty Inhibitors,research,lifescience,medical or heart transplantation.8
We believe that the factors determining the rate of progression are important, and it is in this context the that we wish to propose for the first time the term “atherosclerosis velocity”. Although the term “velocity” has not been previously employed in the context of atherosclerosis, we believe that this terminology and several aspects thereof can be drawn upon in a user-friendly way in future research. Basically, velocity is a parameter often used in physics and expresses “the rate of change of the position of an object, equivalent to a specification of its speed and direction of motion”.9 Velocity describes both how fast (i.e., time-dependent progression) and in what direction the object is moving. Therefore, we herein propose the term “atherosclerosis velocity” by taking into consideration plaque stability/vulnerability, which accelerates the final phase of atherosclerosis.