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J Am Coll Cardiol, 2007; 50:2171, doi:10.1016/j.jacc.2007.07.077 (Published online 12 November 2007).
© 2007 by the American College of Cardiology Foundation
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CORRESPONDENCE: LETTER TO THE EDITOR

Complex Roles of Endothelial Shear Stress in Vascular Remodeling Response

Hideaki Kaneda, MD, PhD*

* Center for Research in Cardiovascular Interventions, Stanford University Medical Center, 300 Pasteur Drive, Room H3554, Stanford, California 94305 (Email: hdkaneda{at}gmail.com).

With great interest I read the review article by Chatzizisis et al. (1) regarding endothelial shear stress (ESS), coronary atherosclerosis, and vascular remodeling. The authors stated in the text, "Recent observations, however, indicate that low ESS leads to excessive expansive remodeling ..." from their diabetic hyperlipidemic swine model. However, in their previous human study (2), they demonstrated that constrictive remodeling occurred more frequently (44%) than expansive remodeling (22%) in subsegments with low ESS, whereas expansive remodeling occurred more frequently (26.3%) than constrictive remodeling (5.3%) in subsegments with moderate/higher ESS. These results suggest complex roles of ESS in the vascular remodeling response, depending on concomitant conditions including atherosclerotic stage, in addition to differences in biology between experimental models and clinical studies (3,4). Further clinical studies are warranted to determine the role of ESS in vascular remodeling in humans.


   References
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 References
 

  1. Chatzizisis YS, Coskun AU, Jonas M, Edelman ER, Feldman CL, Stone PH. Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior J Am Coll Cardiol 2007;49:2379-2393.[Abstract/Free Full Text]
  2. Stone PH, Coskun AU, Kinlay S, et al. Regions of low endothelial shear stress are the sites where coronary plaque progresses and vascular remodelling occurs in humans: an in vivo serial study Eur Heart J 2007;28:705-710.[Abstract/Free Full Text]
  3. Schwartz RS, Chronos NA, Virmani R. Preclinical restenosis models and drug-eluting stents: still important, still much to learn J Am Coll Cardiol 2004;44:1373-1385.[Abstract/Free Full Text]
  4. Dirksen MT, Laarman GJ, Simoons ML, Duncker DJ. Reperfusion injury in humans: a review of clinical trials on reperfusion injury inhibitory strategies Cardiovasc Res 2007;74:343-355.[Abstract/Free Full Text]

Related Articles

Complex Roles of Endothelial Shear Stress in Vascular Remodeling Response
Hideaki Kaneda
J. Am. Coll. Cardiol. 2007 50: 2171. [Full Text] [PDF]

Reply
Yiannis Chatzizisis, Ahmet Umit Coskun, Michael Jonas, Elazer R. Edelman, Charles L. Feldman, and Peter H. Stone
J. Am. Coll. Cardiol. 2007 50: 2171-2172. [Full Text] [PDF]




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