PATHOGENESIS OF ATHEROSCLEROSIS

Atherosclerosis is a chronic disease, the main manifestations of which are associated with the formation of atheromatous plaques specific to this pathology in the artery wall, causing a violation of blood flow in organs and tissues. The insidiousness of atherosclerosis is that it is asymptomatic for a long time and does not manifest clinically until the blood circulation of the corresponding organ is disrupted.As a rule, symptoms of ischemia appear with stenosis of the vessel lumen by more than 50% (the so-called hemodynamically significant stenosis). Most often, the aorta, arteries of the heart, brain, lower extremities and kidneys undergo atherosclerotic changes. Therefore, among the causes of death in the first place are coronary heart disease (CHD), myocardial infarction, rupture of an aneurysm of the aotra, ischemic or hemorrhagic stroke [1, 2]. Atherosclerosis is a multifactorial disease, the risk of which is determined by a combination of several of them. The figurative expression of the German scientist M. Burger is known that "the physiological sclerosis of the elderly is fate, and atherosclerosis is a disease." However, it is important to note that although atherosclerosis is not the result of the physiological aging process of the body, there are certain correlations between atherosclerosis and age. The initial signs of atherosclerosis are detected on the section already at the age of 20. However, clinical manifestations of the disease are most often found in people older than 30-40 years, when there is already hemodynamically significant vascular stenosis [1, 2]. Although the primary processes leading to the formation of fat strips are unknown, experiments conducted on animals suggest that early endothelial dysfunction occurs under stress. At the same time, modified lipids enter the layers located behind the intima. They are mediators of inflammation and ensure the mobilization of leukocytes and the formation of foam cells, which is a characteristic pathogenetic feature of fat strips. Atherosclerosis comes from the Greek word Athero, meaning gruel. Marchand coined the term "atherosclerosis", describing the association of fatty dystrophy and vascular stiffness. This is a mottled intramuscular thickening of the subintima. The earliest lesion is a fat band. Fat bands develop into fibrous plaques, and unstable plaques are responsible for various clinical manifestations. Damage to the arterial wall endothelium is an early pathogenetic event of atherosclerosis. The arterial wall is a dynamic regulating system. However, damaging factors can disrupt normal homeostasis and ensure the onset of atherosclerosis.

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