Atherosclerosis Pathogenesis and Microvascular Dysfunction
This book provides new perspectives on the pathogenesis of atherosclerosis. Chapters cover atherosclerosis risk factors, the effect of growth and aging on vascular architecture, and the crucial role the microvasculature plays in atherosclerosis developmen
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Atherosclerosis Pathogenesis and Microvascular Dysfunction
Axel Haverich · Erin Colleen Boyle
Atherosclerosis Pathogenesis and Microvascular Dysfunction
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Axel Haverich Hannover Medical School Hannover, Niedersachsen, Germany
Erin Colleen Boyle Hannover Medical School Hannover, Niedersachsen, Germany
ISBN 978-3-030-20244-6 ISBN 978-3-030-20245-3 (eBook) https://doi.org/10.1007/978-3-030-20245-3 © Springer Nature Switzerland AG 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
To my patients and colleagues Axel Haverich To Orla and Kilian Graßl Erin Colleen Boyle
Preface
Based on surgical observations, I’ve remained critical about many of the hypotheses regarding the pathogenesis of atherosclerosis, since two important paradigms appear to be incorrect. First, atherosclerosis is not a generalized disease as defined segments of the arterial tree in humans are nearly always disease-free. Second, disease is not instigated in the endothelium of the parent vessel. Growing evidence and my observations support an “outside-in” initiation and progression of atherosclerosis development whereby vascular inflammation is initiated in the adventitia and is propagated inward toward the intima. Cardiovascular surgeons from around the world would support this. These observations led me on a 6-year journey of research via the Internet. Very soon, though, other sources like international libraries and historic bookshops were involved providing me with remote articles and “ancient” books from the nineteenth and early twentieth centuries. I drew upon these to form the picture of the pathogenesis of atherosclerosis presented in this book. Relating my theory of atherosclerosis development over coff
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