Blood flow and arterial endothelial dysfunction: Mechanisms and implications

The arterial endothelium exquisitely regulates vascular function, and endothelial dysfunction plays a critical role in the development of atherosclerosis. Atherosclerotic lesions develop preferentially at arterial branches and bifurcations where the blood flow is disturbed. Understanding the basis for this observation requires elucidating the effects of blood flow on the endothelial cell (EC) function. The goal of this review is: (1) to describe our current understanding of the relationships between arterial blood flow and atherosclerosis, (2) to present the wide array of flow-induced biological responses in ECs, and (3) to discuss the mechanisms by which ECs sense, transmit, and transduce flow-derived mechanical forces. We conclude by presenting some future perspectives in the highly interdisciplinary field of EC mechanotransduction.