Atherosclerosis timeline - endothelial dysfunction

A fatty streak is the first grossly visible (visible to the naked eye) lesion in the development of atherosclerosis. It appears as an irregular yellow-white discoloration on the luminal surface of an artery. It consists of aggregates of foam cells, which are lipoprotein-loaded

macrophage Macrophages (abbreviated as M φ, MΦ or MP) ( el, large eaters, from Greek ''μακρός'' (') = large, ''φαγεῖν'' (') = to eat) are a type of white blood cell of the immune system that engulfs and digests pathogens, such as cancer cel ...

s, located in the intima, the innermost layer of the artery, beneath the

endothelial cell The endothelium is a single layer of squamous endothelial cells that line the interior surface of blood vessels and lymphatic vessels. The endothelium forms an interface between circulating blood or lymph in the lumen and the rest of the vessel ...

s that layer the lumina through which blood flows. Fatty streaks may also include T cells, aggregated platelets, and smooth muscle cells. It is the precursor lesion of atheromas that may become atheromatous plaques.

Epidemiology

Almost all children older than 10 in developed countries have

aortic The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes ox ...

fatty streaks, with coronary fatty streaks beginning in

adolescence Adolescence () is a transitional stage of physical and psychological development that generally occurs during the period from puberty to adulthood (typically corresponding to the age of majority). Adolescence is usually associated with the t ...

.Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007). ''Robbins Basic Pathology'' (8th ed.). Saunders Elsevier. pp. 348-351 In 1953, a study was published that forever changed the understanding of the development of heart disease. The study examined the results of 300 autopsies performed on U.S. soldiers who had died in the Korean War. Despite the fact that the average age of the soldiers was just 22 years old, 77% of them had visible signs of coronary atherosclerosis. This study showed that heart disease could affect people at a young age and was not just a problem for older individuals. In 1992, a report had shown that microscopic fatty streaks were noticed in the left anterior descending artery in over 50% of children aged 10–14. And 8% had more notable accumulations of extracellular lipid. In a 2005 study carried out between 1985–1995, it was found that around 87% of aortas and 30% of coronary arteries in age group 5–14 years had fatty streaks.

References

{{Vascular diseases Vascular diseases