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Etiopatogeneza ateroskleroze in vzroki za različne lokalizacije aterosklerotičnih lezij = Etiopathogenesis of atherosclerosis and reasons for different location of atherosclerotic lesions
Poredoš, Pavel
The paper discusses the mechanisms of atherogenesis. The key event in atherogenesis is damage to the endothelium, followed by the deposition of lipids and other plasma components onto the vessel ...wall. The development of atherosclerosis is strongly influenced by mechanical and oxidative stress. Both types of stress accompany various risk factors for atherosclerosis and also promote inflammation. Inflammation is most likely the leading pathological process in atherogenesis. This is evidenced by the finding of inflammatory cells in and around atheromatous lesions, as well as by systemic inflammatory markers that serve as reliable pre dictors of cardiovascular ischemic events in patients at risk. Although atherosclerosis is a systemic disease, its predominant site of development varies among individuals. The location of atherosclerotic plaques is to a certain degree influenced by systemic risk factors, and also by the composition of the vascular wall and hemodynamic stress. Arterial hypertension accelerates atherosclerosis especially at the level of the carotid artery bifurcation. Disorders of lipid metabolism are the strongest risk factor for coronary atherosclerosis, whereassmoking is the leading risk factor for peripheral arterial disease. Positive family history is important in coronary and cerebrovascular atherosclerosis, but less important in peripheral arterial disease. These observations confirm that standard risk factors for atherosclerosis are selective to a certain degree and that in addition to systemic effects, local factors also play a role.
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