Influence of Convection and Vasoactive Agents on the Mass Transport Properties of the Arterial Wall

Abstract

A characteristic of the complex process of the development of atheroma is the accumulation of material in the arterial wall. Our initial work in this field involved determining whether the distribution of early atheromatous lesions in arteries is correlated with the local haemodynamics. Our observations indicated that early lesions in man occur preferentially in regions where the wall shear is expected to be low (Caro et al. 1971). Support for that view has come from other laboratories (Friedman et al. 1981; Kjaernes et al. 1981). It was proposed (Caro et al. 1971) that the correlation results from dependence of transitional mass transport on wall shear (Fry 1969; Caro and Nerem 1973) and that accumulation of material in the wall is in part due to alteration of material entering the wall and inadequate efflux of material from wall to blood. Since endothelial damage markedly increases intimai permeability, the hypothesis gains support from the observation that no endothelial damage is evident in arteries (Zarins et al. 1980; Schwartz 1980). The hypothesis is also supported by the finding that low density lipoprotein is present in high concentration in arterial intimai interstitial fluid (Smith and Staples 1982).