Lo lus "atherogenic" yog hais txog cov khoom lossis cov khoom muaj peev xwm tsim tau atheroma, lossis tso cov plaques ua los ntawm LDL-cholesterol, inflammatory cells thiab fibrous plhaub. Qhov tshwm sim no yog qhov txaus ntshai tshwj xeeb yog tias cov hlab ntsha muab lub cev tseem ceeb xws li lub plawv lossis lub hlwb. Nws yog qhov ua rau feem ntau cov kab mob plawv, nrog rau mob stroke thiab myocardial infarction. Nws qhov kev tiv thaiv tseem ceeb yog los ntawm kev coj noj coj ua zoo dua qub thiab noj zaub mov zoo. Kev tiv thaiv thib ob yog muab rau cov neeg mob uas twb muaj tsos mob lossis muaj teeb meem. Nyob rau hauv cov ntaub ntawv no, lub hom phiaj yog kom txo tau qhov kev pheej hmoo ntawm ib qho teeb meem tshiab, nyob rau tib lub teb chaws los yog nyob rau lwm qhov chaw ntawm vascular.

Lo lus "atherogenic" yog hais txog cov khoom lossis cov khoom muaj peev xwm tsim tau cov atheroma, uas yog hais txog kev tso nyiaj ntawm cov plaques ua los ntawm lipids, inflammatory cells, cov leeg nqaij du thiab cov ntaub so ntswg. Cov plaques txuas lawv tus kheej mus rau sab hauv phab ntsa ntawm cov hlab ntsha nruab nrab thiab cov hlab ntsha loj, tshwj xeeb tshaj yog cov plawv, hlwb thiab ob txhais ceg, thiab ua rau muaj kev hloov kho hauv zos ntawm cov tsos thiab qhov xwm txheej ntawm cov phab ntsa. 

Kev tso tawm ntawm cov plaques tuaj yeem ua rau muaj teeb meem loj xws li kab mob coronary artery los ntawm kev ua rau:

• thickening thiab poob ntawm elasticity ntawm phab ntsa hlab ntsha (atherosclerosis);
• txo qis hauv txoj kab uas hla ntawm cov hlab ntsha (stenosis). Qhov tshwm sim no tuaj yeem ncav cuag ntau dua 70% ntawm txoj kab uas hla ntawm cov hlab ntsha. Qhov no hu ua nruj stenosis;
• ib nrab los yog tag nrho cov hlab ntsha (thrombosis).

Peb hais txog kev noj zaub mov atherogenic kom xaiv cov khoom noj muaj roj, xws li cov khoom noj sab hnub poob uas tshwj xeeb yog nplua nuj nyob rau hauv cov roj saturated thiab trans fatty acids tom qab hydrogenation ntawm fatty acids los ntawm kev lag luam.

Kev loj hlob ntawm atheromatous plaques tuaj yeem yog vim muaj ntau yam, tab sis qhov tseem ceeb yog cov roj cholesterol ntau dhau hauv cov ntshav, lossis hypercholesterolemia. Qhov tseeb, kev tsim cov atheromatous plaque nyob ntawm qhov sib npaug ntawm kev noj zaub mov kom tsawg ntawm cov roj cholesterol, nws cov qib thiab kev tshem tawm.

Thaum lub sij hawm lub neej, ib tug xov tooj ntawm mechanisms yuav xub tsim breaches nyob rau hauv lub arterial phab ntsa, tshwj xeeb tshaj yog nyob rau hauv lub bifurcation cheeb tsam:

• arterial hypertension uas, ntxiv rau nws cov neeg kho tshuab kev ua haujlwm ntawm phab ntsa, hloov cov lipoproteins intracellular ntws;
• vasomotor tshuaj, xws li angiotensin thiab catecholamines, uas tswj kom nthuav tawm cov sub-endothelial collagen;
• Cov tshuaj hypoxiant, xws li nicotine, uas ua rau muaj kev ntxhov siab ntawm cellular uas ua rau kev sib kis ntawm intercellular junctions.

Cov kev ua txhaum cai no yuav tso cai rau nkag mus rau hauv cov phab ntsa ntawm cov lipoproteins me me xws li HDL (High Density Lipoprotein) thiab LDL (Low Density Lipoprotein) lipoproteins. LDL-cholesterol, feem ntau hu ua "cov roj (cholesterol) phem", muaj nyob hauv cov hlab ntsha tuaj yeem tsim. Nws yog li tsim thawj qhov mob thaum ntxov, hu ua lipid streaks. Cov no yog cov deposits uas tsim tsa lipid txoj kev ntawm sab hauv phab ntsa ntawm cov hlab ntsha. Me ntsis los ntawm me ntsis, LDL-cholesterol oxidizes muaj thiab ua rau cov phab ntsa sab hauv. Txhawm rau tshem tawm nws, tom kawg nrhiav cov macrophages uas yog gorged nrog LDL-cholesterol. Sib nrug los ntawm cov txheej txheem tswj hwm, macrophages ua loj, tuag los ntawm apoptosis thaum tseem nyob hauv zos. Cov kab ke ib txwm ntawm kev tshem tawm cov khib nyiab ntawm tes tsis tuaj yeem cuam tshuam, lawv khaws cia rau hauv cov quav hniav atheroma uas loj tuaj. Hauv kev teb rau cov txheej txheem no, cov leeg nqaij leeg ntawm phab ntsa vascular migrate rau hauv cov quav hniav hauv kev sim cais cov kab mob inflammatory cell. Lawv yuav tsim ib tug fibrous screed ua los ntawm collagen fibers: tag nrho cov ntaub ntawv ib tug ntau los yog tsawg nruj thiab ruaj khov phaj. Nyob rau hauv tej yam kev mob, plaque macrophages tsim proteases muaj peev xwm zom cov collagen uas ua los ntawm cov leeg nqaij leeg. Thaum qhov tshwm sim no tshwm sim ua rau mob ntev, qhov kev txiav txim ntawm proteases ntawm cov fibers txhawb kev ua kom zoo ntawm cov screed uas ua rau tawg yooj yim dua thiab tuaj yeem tawg. Hauv qhov no, sab hauv phab ntsa ntawm cov hlab ntsha tuaj yeem tawg. Cov ntshav platelets sib sau ua ke nrog cov khib nyiab ntawm tes thiab lipids sau hauv cov quav hniav los tsim cov hlab ntsha, uas yuav qeeb thiab tom qab ntawd thaiv cov ntshav.

Kev khiav ntawm cov roj cholesterol hauv lub cev yog muab los ntawm LDL thiab HDL lipoproteins uas nqa cov roj cholesterol, los ntawm cov zaub mov hauv cov ntshav, los ntawm txoj hnyuv mus rau daim siab lossis cov hlab ntsha, lossis los ntawm cov hlab ntsha mus rau lub siab. Qhov no yog vim li cas, thaum peb xav ntsuas qhov kev pheej hmoo atherogenic, peb muab cov lipoproteins no thiab sib piv lawv cov khoom:

• Yog tias muaj ntau LDL lipoproteins, uas nqa cov roj cholesterol mus rau cov hlab ntsha, qhov kev pheej hmoo yog siab. Qhov no yog vim li cas LDL-cholesterol hu ua atherogenic;
• Qhov kev pheej hmoo no txo ​​qis thaum cov ntshav HDL lipoproteins, uas ua kom cov roj cholesterol rov qab mus rau lub siab uas nws tau ua tiav ua ntej raug tshem tawm, siab dua. Yog li, HDL-HDL-cholesterol yog tsim nyog raws li cardioprotective thaum nws qib siab, thiab raws li kev pheej hmoo ntawm cov hlab plawv thaum nws qib qis.

Cov thickening ntawm atheromatous plaques tuaj yeem maj mam cuam tshuam nrog cov ntshav ntws thiab ua rau pom cov tsos mob hauv zos:

• mob;
• kiv taub hau;
• txog siav;
• instability thaum taug kev, thiab lwm yam.

Cov teeb meem loj ntawm atherosclerosis tshwm sim los ntawm kev tawg ntawm atherosclerotic plaques, uas ua rau tsim cov hlab ntsha los yog thrombus, uas ua rau cov ntshav ntws thiab ua rau ischemia, qhov tshwm sim ntawm qhov tshwm sim tuaj yeem loj lossis tuag taus. Cov hlab ntsha ntawm cov kabmob sib txawv tuaj yeem cuam tshuam:

• kab mob coronary artery, nyob rau hauv lub plawv, nrog angina los yog angina pectoris raws li ib tug tshwm sim, thiab muaj kev pheej hmoo ntawm myocardial infarction;
• carotids, nyob rau hauv lub caj dab, muaj kev pheej hmoo ntawm cerebrovascular kev huam yuaj (stroke);
• lub plab aorta, nyob rau hauv lub diaphragm, muaj kev pheej hmoo ntawm aneurysm rupture;
• cov hlab ntsha digestive, nyob rau hauv txoj hnyuv, muaj kev pheej hmoo ntawm mesenteric infarction;
• lub raum cov hlab ntsha, nyob rau theem ntawm lub raum, muaj kev pheej hmoo ntawm lub raum infarction;
• cov hlab ntsha ntawm cov ceg qis nrog cov tsos mob ntawm cov hlab ntsha ntawm cov ceg qis.

Sib nrug los ntawm heredity, poj niam txiv neej thiab hnub nyoog, kev tiv thaiv ntawm kev tsim cov atheromatous plaques yog nyob ntawm kev kho cov kab mob plawv:

• tswj qhov hnyav, ntshav siab thiab ntshav qab zib;
• txiav luam yeeb;
• kev tawm dag zog lub cev tas li;
• kev coj noj coj ua noj qab haus huv;
• txwv kev haus cawv;
• kev tswj kev ntxhov siab, thiab lwm yam.

Thaum cov atheromatous plaque tsis tseem ceeb thiab tsis ua rau muaj kev cuam tshuam, qhov kev tiv thaiv thawj zaug yuav txaus. Yog tias thawj qhov kev ntsuas no ua tsis tiav, thaum cov quav hniav tau hloov zuj zus lawm, kev kho tshuaj yuav raug pom zoo. Nws tseem tuaj yeem muab tshuaj ncaj qha yog tias muaj kev pheej hmoo siab ntawm cov teeb meem. Nws raug pom zoo rau kev tiv thaiv theem nrab tom qab thawj qhov tshwm sim ntawm cov hlab plawv. Kev kho tshuaj no suav nrog:

• tshuaj antiplatelet, xws li tshuaj aspirin hauv koob tshuaj me me, kom txo cov ntshav;
• lipid-txo cov tshuaj (statins, fibrates, ezetimibe, cholestyramine, ib leeg lossis ua ke) nrog lub hom phiaj ntawm kev txo qis cov roj cholesterol, normalizing qib roj cholesterol thiab stabilizing atheromatous plaques.

Tau ntsib nrog cov atheromatous plaques nrog nruj stenosis, revascularization los ntawm coronary angioplasty yuav raug txiav txim siab. Qhov no tso cai rau dilate lub atheromatous cheeb tsam ua tsaug rau ib tug inflated balloon thaj chaw nyob rau hauv cov hlab ntsha nrog ischemia. Txhawm rau kom tswj tau qhov qhib thiab kho cov ntshav ntws, lub tshuab me me hu ua stent raug ntsia thiab tso rau hauv qhov chaw.