June 17, 2026Journal of the American College of Cardiology
Role of Endothelial Shear Stress in the Natural History of Coronary Atherosclerosis and Vascular Remodeling
Key result
Low endothelial shear stress promotes high-risk coronary plaques via lipid accumulation and excessive expansive remodeling.
Why the study?
The pathophysiologic mechanisms involved in the remodeling of the atherosclerotic wall are incompletely understood, but the interplay between local hemodynamics, low endothelial shear stress, and wall biology is likely important.
Design
Review
Authors
Discussion
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Implication
May support future high-risk plaque identification; leaves open whether shear stress modulation improves outcomes.
Key Points
- The aim is to explore the impact of endothelial shear stress on coronary atherosclerosis and the associated vascular remodeling processes.
- Review of molecular, cellular, and vascular processes related to low endothelial shear stress and atherosclerosis.
- Analysis of the interplay between hemodynamic conditions and plaque natural history trajectories.
- Low endothelial shear stress is linked to the formation of an atherogenic endothelial phenotype.
- Plaques under low shear stress show a tendency for progressive remodeling and lipid accumulation.
- Understanding these mechanisms may aid in identifying high-risk plaques for better management of coronary patients.
PICO
P
Population
Coronary atherosclerosis and vascular remodeling
E
Exposure / Comparator
Low endothelial shear stress
Low endothelial shear stress plays a critical role in the progression of coronary atherosclerosis and the development of high-risk plaques through excessive expansive remodeling.
Cite This Study
Chatzizisis et al. (2007) conducted a review in Coronary atherosclerosis and vascular remodeling. Low endothelial shear stress was evaluated. Low endothelial shear stress promotes the formation and progression of high-risk coronary atherosclerotic plaques through local lipid accumulation and excessive expansive remodeling.