Key result
Fluid shear stress drives arteriogenesis primarily by reprogramming endothelial gene expression.
Why the study?
Current revascularization therapies have limited application and therapeutic effects in elderly patients with coronary diseases, and the mechanisms of arteriogenesis remain to be elucidated.
Understanding the hydromechanical triggers of arteriogenesis may help develop novel therapeutic strategies for promoting collateral circulation in elderly patients with coronary disease.
Answers are grounded in this paper and cite their sources.
Supports investigation of shear stress-targeted therapies to promote collaterals in elderly CAD; leaves open clinical translation pending prospective studies.
Coronary heart diseases are tightly associated with aging. Although current revascularization therapies, such as percutaneous coronary interventions (PCI) and coronary artery bypass graft (CABG), improve the clinical outcomes of patients with coronary diseases, their application and therapeutic effects are limited in elderly patients. Thus, developing novel therapeutic strategies, like prompting collateral development or the process of arteriogenesis, is necessary for the treatment of the elderly with coronary diseases. Arteriogenesis (ie, the vascular remodeling from pre-existent arterioles to collateral conductance networks) functions as an essential compensation for tissue hypoperfusion caused by artery occlusion or stenosis, and its mechanisms remain to be elucidated. In this review, we will summarize the roles of the major hydromechanical components in laminar conditions in arteriogenesis, and discuss the potential effects of disturbed flow components in non-laminar conditions.
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Ma et al. (2020) conducted a review in Coronary heart disease and arteriogenesis. Hydromechanical forces (fluid shear stress, circumferential wall stress, longitudinal wall stress) was evaluated. Fluid shear stress acts as the primary trigger for arteriogenesis by reprogramming endothelial gene expression, while other mechanical forces also contribute to collateral vessel development.
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