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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2007;27:1722.)
© 2007 American Heart Association, Inc.

Brief Reviews

Vascular Remodeling

Hemodynamic and Biochemical Mechanisms Underlying Glagov’s Phenomenon

Vyacheslav A. Korshunov; Stephen M. Schwartz; Bradford C. Berk

From the Cardiovascular Research Institute and Department of Medicine (V.A.K., B.C.B.), University of Rochester, NY; and the Department of Pathology (S.M.S.), University of Washington, Seattle, Wash.

Correspondence to Vyacheslav "Slava" A. Korshunov, University of Rochester, 601 Elmwood Ave, Box 679, Rochester, NY 14642. E-mail Slava_Korshunov{at}URMC.rochester.edu

An important concept for vascular remodeling, termed Glagov’s phenomenon, is that arteries remodel to maintain constant flow despite increases in atherosclerotic lesion mass. Although Glagov’s phenomenon was originally described only for the case of arterial remodeling in response to growth of atherosclerotic plaques, experimental and clinical observations indicate that blood flow properties influence remodeling after angioplasty, hypertension, and flow diversion as well as atherosclerotic plaque progression. This review attempts to define Glagov’s observation in terms of the physical parameters of blood in conduit arteries that must determine the remodeling response. Next we review experiments that have begun to identify specific molecules that influence vascular remodeling and therefore may serve as mediators for the phenomena. More comprehensive analyses of the specific molecular pathways in the vessels that determine constant flow may provide new therapeutic approaches to regulate vascular remodeling.

This review focuses attention on the need to identify specific molecular pathways that explain the relationship of physical parameters and arterial remodeling. Recent studies have begun to define the transduction pathways in the artery wall that determine their ability to respond to the physical forces exerted by blood flow.

Key Words: vascular remodeling • Glagov’s phenomenon • shear stress

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