Annotated Bibliography on the Mechanism Starting and Sustaining Atherosclerosis

Abstract

Background: In the past 30 years, there has been a significant rise in coronary artery disease (CAD) and atherosclerosis, primarily attributed to dietary changes toward cholesterol-rich fast foods. Traditional research methodologies focusing on molecular biology have been insufficient in fully understanding the initiation mechanisms of these conditions. This paper reviews the literature and defines the knowledge gap for the need for a new dynamic coronary angiographic technique. Methods: Our approach involved a comprehensive review of fluid mechanics literature to identify gaps in current CAD research. This included analyzing major works from standard physiology textbooks, fluid mechanics reviews, and bioengineering journals. The study also introduced a new technique, "Dynamic Coronary Angiography," aimed at identifying and analyzing blood flow characteristics in coronary arteries using the principles and practices of fluid dynamics. Results: The literature review highlighted the pulsatile nature of coronary blood flow and the importance of wall shear stress (WSS) in the development of atherosclerosis. However, existing research showed limitations such as reduced applicability of animal model data to human pathophysiology and simplistic experimental designs. The new angiographic technique revealed various flow patterns in cardiac cycle phases, including laminar, turbulent, and retrograde flows, and their possible impacts on the arterial wall. Conclusions: Our findings suggest that turbulent flow may be critical in initiating atherosclerosis by damaging endothelial cells. This new perspective on the role of blood flow dynamics in CAD provides a promising avenue for understanding plaque formation and growth, potentially leading to significant advancements in cardiovascular medicine.