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Table 1 Natural History of Human Coronary Atherosclerotic Plaque

From: Ultrasound imaging versus morphopathology in cardiovascular diseases. Coronary atherosclerotic plaque

Beliefs

Facts

Transendothelial lipoprotein/cholesterol infiltration

Nodular smooth myocell-elastic hyperplasia protruding in lumen

Fatty streaks

Fibrous substitution

Macrophagic "inflammation"

Proteoglycan accumulation below fibrous cap between media/intima

Necrotic core-atheroma under fibrous cap

Interstitial/macrofagic (foam cells) storage of lipoprotein-cholesterol and/or calcium salts in proteoglycan pool

Rupture fibrous cap

Plaque tridimensional growth by recurrence of previous phenomena

Thrombosis-Embolization

Late vascularization of atherosclerotic intima

  1. Divergency between dogma and heretic view is easily explained by the fact that the former is founded on experimental hypercholesterolemic plaque which more or less may correspond to plaques in the relatively small group of familial hypercholesterolemia in humans. Furthermore, the main arterial vessel examined was the aorta and in human pathology advanced plaque was not studied comparing study in different CHD patterns and pathologic and normal controls.
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Cardiovascular Ultrasound

ISSN: 1476-7120

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