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(Circulation Research. 2006;99:6.)
© 2006 American Heart Association, Inc.

Editorials

Flow-Dependent Remodeling of Small Arteries

The Stimuli and the Sensors Are (Still) in Question

Akos Koller

From the Department of Physiology, New York Medical College, Valhalla; and the Department of Pathophysiology, Semmelweis University, Budapest, Hungary.

Correspondence to Akos Koller MD, PhD, Department of Physiology, New York Medical College, Valhalla NY 10595. E-mail koller@nymc.edu

See related article, pages 86–92

Key Words: vascular remodeling • transglutaminase • resistance arteries • macrophages • flow • shear stress

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
From the embryonic state to the end of life, the elements of the circulatory system are exposed to hemodynamic forces associated with the circulation of blood. Various levels of intraluminal (transmural) pressure and wall shear stress represent the natural environment for the tissues of the vascular wall. Physiological or pathological changes in the level of these forces elicit active responses in the cellular and noncellular elements of the vascular wall. In the short-term, vessels may change their functional diameter, whereas, if the hemodynamic forces are altered chronically, this results in morphological changes of the wall, indicated by changes in vessel diameter and wall thickness, frequently termed remodeling, aimed at minimizing the effect of altered hemodynamic forces on the vascular wall.

	Pressure-Induced Remodeling of Vessels

 
A change in intraluminal pressure was the first to be recognized widely as a potential stimulus for functional or morphological changes in vessel diameter.^1–3 Indeed, vascular remodeling was recognized as an important factor in the stable increase in peripheral resistance in hypertension, a disease in which the intraluminal pressure is elevated.^1–4 There are ample original publications and reviews on this subject.^1–4 The present editorial focuses on the remodeling of vessels that are initiated by a change in blood flow.

	Flow-Induced Remodeling of Vessels

 
Early Findings on the Effects of Chronic Alterations of Blood Flow
In 1893, Thoma summarized, with great insight, his own and other investigators’ ideas describing the relationship between blood flow and vascular dimensions. He posited that growth of the "cross-diameter" of vessels was dependent on the velocity of blood flow. Recklinghausen (1883) and Nothnagel (1889) drew similar conclusions, namely, that it is . . . [Full Text of this Article]

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