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Coronary heart disease 

Coronary heart disease
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date: 05 March 2021

Atherosclerotic plaques are not randomly distributed, but tend to form at the inner curvatures and branch points of arteries, where laminar flow is either disturbed or insufficient to support the normal, quiescent state of the endothelium (the lining of endothelial cells that separates the circulating blood from the arterial wall). This is an inflammatory process that involves the contribution of endothelial cells, lymphocytes, monocytes, and smooth muscle cells in conjunction with the deposition of atherogenic lipoproteins in the intimal layer of the vascular wall. The initial stage involves activation of the endothelium at regions of non-laminar flow in vessels resulting in increased permeability to Apo B-containing lipoproteins. Inflammatory cells, in particular monocytes, are recruited into the intimal layer of the vessel wall via the action of chemokines and adhesion molecules mobilized by activated endothelium.

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