1846COLIC M et al.
Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp stress may be involved in the transport of atherogenic substances and their subsequent redistribution within the vessel wall. 9-13 Compared to other mechanical forces, shear stress acts on a surface of the blood vessel wall (endothelium) 14 and appears to be particularly important. Studies showed endothelial cell dysfunction in areas of low shear stress, which also demonstrate increased uptake of lipoproteins. 9,15-19 The goal of this work was to examine LDL uptake by the blood vessel wall in a very short period of time, taking into account shear stress variation and possible influence of cholesterol exposure to the blood vessel wall. All previous studies that examined LDL transport and accumulation into the blood vessel wall were performed either on isolated blood vessel strips 20 or segments. 21 These were done either without perfusion flow or in vitro, using cultured endothelial cell monolayers 22 or they were performed by using mathematical and computational models of blood vessels 18,23,24 based on experimental results, especially those of Meyer et al. 21 This study t is known that the leading cause of death worldwide is coronary artery disease (CAD), and special attention is given to atherosclerosis, mainly dyslipidemia, as an important risk factor for CAD. 1 Atherosclerosis, a chronic fibroproliferative disease of the arterial wall, occurs principally in large-and medium-sized elastic and muscular arteries and may induce ischemia of the heart, brain or extremities, resulting in infarction. 2-4 Because high plasma concentrations of cholesterol, particularly low-density lipoprotein (LDL) cholesterol, represent one of the principal risk factors for atherosclerosis, 5 the process of atherogenesis has been considered by many to consist largely of the accumulation of lipids within the artery wall. 6 By providing cholesterol to peripheral tissues, LDL is the key component in physiological cholesterol metabolism. 7, 8 Furthermore, blood vessels are constantly exposed to various types of hemodynamic forces induced by the pulsatile blood flow and pressure, and the spatial distribution of these hemodynamic factors such as wall pressure, fluid velocity or wall shear I