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Flashcards in atherosclerosis Deck (19):
1

Define ateriosclerosis

Hard arteries

2

Define atherosclerosis

A type of arteriosclerosis with fatty build-up

3

Define fibroatheroma

A type of arteriosclerosis with fatty and fibrous build up

4

atherothrombosis

Atherosclerosis with thrombosis

5

How do endothelial cells normally prevent atherosclerosis?

How are they stimulated to respond normally?

- maintain an antithrombotic surface
- low propensity to synthesize ECM
- produce antioxidants and antithrombotics
-produce NO, keep SMCs relaxed

- normal laminar flow (shear stress)

6

How does atherosclerosis start?

- endothelial injury. Can be chemical irritants (tobacco smoke, lipids, glucose) or physical (HTN, branch points

7

What sort of things do abnormal (dysfunctional) epithelial cells do ?

-altered permeability
-prothrombotic
-pro-leukocyte adhesion
-poor vasodilation
-secretion of growth factors
-increased oxidative state

8

What are the steps in atherogenesis?

1) endothelial injury
3) LDL and leukocytes get into the subendothelial space
4) T-cells produce cytokines
5) Macrophages eat LDL and become foam cells, die

At the same time, smooth muscles are transformed into spastic, migratory cells by the inflammation. Lots of ECM is produced

9

Differentiate between compensatory remodelling and non-compensatory

Compensatory grows out so the lumen does get occluded too much

Non-compensatory grows into the lumen

10

Contribution of platelets in atherogenesis

- they are activated by injured endothelium, and may clot causing further irritation of endothelium.

11

Characteristics of stable and vulnerable plaques

Stable: thick fibrous cap, many SMCs and collagen, small lipid core, few foam cells and little inflammation, lots of calcium

Vulnerable plaques are the opposite of this...

12

How does smoking contribute to atherosclerosis?

Smoking is associated with more oxidized LDL, endothelial dysfunction, increased platelet reactivity

13

How does diabetes contribute to atherosclerosis?

Glycated LDL leads to endothelial dysfunction

14

How does hypertension contribute to atherosclerosis?

- barotrauma
-AngII promotes oxidation

15

Define: atheroma

The fatty material that forms part of an atherosclerotic plaque

16

What makes the fibrous cap?

-myofibroblasts secreting ECM (collagen)
- these are cardiomyocytes that are differentiated/activated to produce ECM

17

Effect of atherosclerosis on tunica media

It becomes thinner in the area of the plaque

18

Differentiate between coronary artery disease and coronary heart disease

Coronary artery disease: 70% reduction in lumenal area

19

Physical findings that are specific for CAD

There are no findings that are specific for CAD