Izwi rekuti "atherogenic" rinoreva zvinhu kana zvinhu zvinokwanisa kuburitsa atheroma, kana dhipoziti yemaplaques anoumbwa neLDL-cholesterol, masero ekuzvimba uye fibrous shell. Chiitiko ichi chine njodzi zvakanyanya kana tsinga ichipa nhengo yakakosha semoyo kana uropi. Ndicho chikonzero chezvirwere zvakawanda zvemwoyo, kusanganisira sitiroko uye myocardial infarction. Kudzivirirwa kwayo kwekutanga kunosanganisira kutora hutsanana uye tsika dzekudya. Kudzivirirwa kwechipiri kunopihwa kune varwere vatova nezviratidzo kana complication. Muchiitiko ichi, chinangwa ndechekuderedza dambudziko rekugadzirisa kutsva, panzvimbo imwe chete kana kune imwe nzvimbo yevascular.

Izwi rekuti "atherogenic" rinoreva zvinhu kana zvinhu zvinokwanisa kuburitsa atheroma, kureva dhipoziti yematombo anoumbwa ne lipids, masero ekuzvimba, akatsetseka mhasuru maseru uye anobatanidza tishu. Aya ma plaque anozvisungirira kumadziro emukati epakati uye makuru arteries, kunyanya iwo emoyo, uropi nemakumbo, uye anotungamira kugadziriso yenzvimbo yekuonekwa uye chimiro chemadziro aya. 

Kuiswa kweaya maplaque kunogona kutungamirira kumatambudziko akakomba senge coronary artery chirwere nekukonzera:

• kukora uye kurasikirwa kwekusimba kwe arterial wall (atherosclerosis);
• kuderera kwehupamhi hwetsinga (stenosis). Ichi chiitiko chinogona kusvika kupfuura 70% yedhayamita ye artery. Izvi zvinonzi tight stenosis;
• chikamu kana kuvharika zvachose kwetsinga (thrombosis).

Isu tinotaura nezvekudya kweatherogenic kuratidza chikafu chakapfuma mumafuta, sekudya kwekuMadokero kunonyanya kupfuma mumafuta akazara uye trans fatty acids zvichitevera hydrogenation yemafuta asidhi nekugadzirwa kwemaindasitiri.

Kubudirira kweatheromatous plaques kunogona kukonzerwa nezvikonzero zvakawanda, asi chikonzero chikuru ndechekuwedzera cholesterol muropa, kana hypercholesterolemia. Chokwadi, kusikwa kweatheromatous plaque kunoenderana nechiyero pakati pekudya kwecholesterol, chiyero chekutenderera kwayo uye kubviswa kwayo.

Mukufamba kwehupenyu, nzira dzinoverengeka dzinotanga kugadzira kutyora mumadziro e arterial, kunyanya munzvimbo dze bifurcation:

• arterial hypertension iyo, kuwedzera kune yayo mechanical chiito pamadziro, inoshandura intracellular kuyerera kwe lipoproteins;
• vasomotor zvinhu, senge angiotensin uye catecholamines, iyo inokwanisa kuburitsa iyo sub-endothelial collagen;
• hypoxiant zvinhu, senge nicotine, izvo zvinokonzeresa kushushikana kweserura zvichitungamira mukupararira kweiyo intercellular junctions.

Uku kutyora kunobvumira kupinda mumadziro emadziro ediki lipoprotein akadai seHDL (High Density Lipoprotein) uye LDL (Low Density Lipoprotein) lipoproteins. LDL-cholesterol, inowanzonzi "yakaipa cholesterol", iripo muropa inogona kuvaka. Nokudaro inogadzira maronda ekutanga ekutanga, anonzi lipid streaks. Aya ndiwo madhipoziti anoumba nzira dzakasimudza lipid pamadziro emukati metsinga. Zvishoma nezvishoma, iyo LDL-cholesterol oxidize ipapo uye inova yekuzvimba kumadziro emukati. Kuti azvibvise, ekupedzisira anotora macrophage ayo akazara neLDL-cholesterol. Kunze kwechero nzira yekudzora, macrophages anova akakura, anofa neapoptosis achisara akavharirwa munharaunda. Izvo zvakajairika masisitimu ekubvisa marara emasero asingakwanise kupindira, anounganidza mu atheroma plaque inokura zvishoma nezvishoma. Mukupindura kune iyi nzira, masero akatsetseka emhasuru emadziro evascular anotamira mu plaque mukuedza kuparadzanisa iyi inoputika sero cluster. Ivo vanogadzira fibrous screed inoumbwa necollagen fibers: iyo yese inoumba yakawedzera kana kushoma dhizaini uye yakagadzikana ndiro. Mune mamwe mamiriro ezvinhu, plaque macrophages inoburitsa maprotease anokwanisa kugaya collagen inogadzirwa neyakatsetseka tsandanyama masero. Kana ichi chiitiko chinoputika chikava chisingagumi, chiito cheproteases pamitsipa chinokurudzira kunatswa kwe screed iyo inova isina kusimba uye inogona kuputika. Muchiitiko ichi, rusvingo rwomukati rwe arteri runogona kuputika. Maplatelet eropa anoungana nemarara emasero uye lipids akaunganidzwa muplaque kuti agadzire clot, inozodzikamisa uye yovhara kubuda kweropa.

Kuyerera kwecholesterol mumuviri kunopiwa neLDL uye HDL lipoprotein iyo inotakura cholesterol, kubva mukudya muropa, kubva muura kuenda kuchiropa kana tsinga, kana kubva mutsinga ichienda kuchiropa. Ichi ndicho chikonzero, kana tichida kuongorora njodzi yeatherogenic, tinodhaya aya lipoprotein uye tichienzanisa huwandu hwawo:

• Kana paine akawanda eLDL lipoprotein, anoendesa cholesterol kutsinga, ngozi yacho yakakura. Ichi ndicho chikonzero LDL-cholesterol inonzi atherogenic;
• Iyi njodzi inoderedzwa kana mwero weropa weHDL lipoprotein, uyo unova nechokwadi chekudzoka kwecholesterol kuchiropa kwainogadziriswa isati yabviswa, yakakwira. Nokudaro, HDL-HDL-cholesterol inokodzera secardioprotective kana chiyero chayo chakakwirira, uye sehutano hwehutano hwemwoyo kana huwandu hwayo huri pasi.

Iko kukora kweatheromatous plaques kunogona kukanganisa zvishoma nezvishoma kuyerera kweropa uye kutungamirira mukuonekwa kwezviratidzo zvemunharaunda:

• kurwadziwa;
• chizoro;
• mweya wekufema;
• kusagadzikana pakufamba, nezvimwewo.

Zvinetso zvakakomba zveatherosclerosis zvinomuka kubva pakuputika kweatherosclerotic plaques, zvichiita kuti pave nekuumbwa kwevhavha kana thrombus, iyo inovhara kubuda kweropa uye inokonzera ischemia, migumisiro inogona kuva yakakomba kana kuuraya. Mitsipa yenhengo dzakasiyana inogona kukanganisa:

• coronary artery chirwere, mumoyo, ane angina kana angina pectoris sechiratidzo, uye njodzi yemyocardial infarction;
• carotids, mumutsipa, ane ngozi yecerebrovascular tsaona (stroke);
• iyo abdominal aorta, pasi pe diaphragm, ine ngozi yeaneurysm kuputika;
• tsinga dzekudya, mumatumbo, dzine ngozi ye mesenteric infarction;
• iyo renal arteries, pamwero weitsvo, ine njodzi yerenal infarction;
• tsinga dzemakumbo ezasi ane chiratidzo chekukamhina kwemakumbo ezasi.

Kunze kwekugara nhaka, zvepabonde uye zera, kudzivirira kuumbwa kweatheromatous plaques kunoenderana nekugadziriswa kwemoyo wengozi zvinhu:

• kudzora uremu, high blood pressure uye chirwere cheshuga;
• kurega kusvuta;
• kugara uchirovedza muviri;
• kugamuchirwa kwemaitiro ekudya ane hutano;
• kuderedza kunwa doro;
• stress management, etc.

Kana iyo atheromatous plaque isingakoshi uye isina kukonzera kukanganisa, iyi yekutanga kudzivirira inogona kukwana. Kana aya matanho ekutanga akakundikana, kana plaque yashanduka, kurapwa kwemishonga kunogona kukurudzirwa. Inogonawo kurongerwa pakarepo kana paine njodzi yakakura yekunetsekana. Inokurudzirwa yakarongeka kudzivirira kwechipiri mushure mechiitiko chekutanga chemoyo. Kurapa kwezvinodhaka uku kunosanganisira:

• antiplatelet mishonga, yakadai seaspirin mune zviduku zvishoma, kuderedza ropa;
• lipid-kuderedza mishonga (statins, fibrates, ezetimibe, cholestyramine, yoga kana musanganiswa) nezvinangwa zvekudzikisa yakashata cholesterol mazinga, normalizing cholesterol mazinga uye kudzikamisa atheromatous plaques.

Kutarisana nepamusoro atheromatous plaques ane tight stenosis, revascularization ne coronary angioplasty inogona kufungwa. Izvi zvinobvumira kurerutsa iyo atheromatous zone nekuda kwebharumu rakaputika pa-saiti mutsinga ine ischemia. Kuti uchengetedze kuvhura uye kudzoreredza kuyerera kweropa, kamuchina kadiki kanonzi stent inoiswa uye inosiiwa panzvimbo.