Resilience of the Internal Mammary Artery to Atherogenesis: Shifting From Risk to Resistance to Address Unmet Needs
Fueled by the global surge in aging, atherosclerotic cardiovascular disease reached pandemic dimensions putting affected individuals at enhanced risk of myocardial infarction, stroke, and premature death. Atherosclerosis is a systemic disease driven by a wide spectrum of factors, including cholester...
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Published in | Arteriosclerosis, thrombosis, and vascular biology Vol. 41; no. 8; pp. 2237 - 2251 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.08.2021
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Subjects | |
Online Access | Get full text |
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Summary: | Fueled by the global surge in aging, atherosclerotic cardiovascular disease reached pandemic dimensions putting
affected individuals at enhanced risk of myocardial infarction, stroke, and premature death. Atherosclerosis is a systemic
disease driven by a wide spectrum of factors, including cholesterol, pressure, and disturbed flow. Although all arterial beds
encounter a similar atherogenic milieu, the development of atheromatous lesions occurs discontinuously across the vascular
system. Indeed, the internal mammary artery possesses unique biological properties that confer protection to intimal growth
and atherosclerotic plaque formation, thus making it a conduit of choice for coronary artery bypass grafting. Its endothelium
abundantly expresses nitric oxide synthase and shows accentuated nitric oxide release, while its vascular smooth muscle
cells exhibit reduced tissue factor expression, high tPA (tissue-type plasminogen activator) production and blunted migration
and proliferation, which may collectively mitigate intimal thickening and ultimately the evolution of atheromatous plaques.
We aim here to provide insights into the anatomy, physiology, cellular, and molecular aspects of the internal mammary artery
thereby elucidating its remarkable resistance to atherogenesis. We propose a change in perspective from risk to resilience to
decipher mechanisms of atheroresistance and eventually identification of novel therapeutic targets presently not addressed
by currently available remedies. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1079-5642 1524-4636 |
DOI: | 10.1161/ATVBAHA.121.316256 |