Atherosclerosis preferentially occurs in arterial regions exposed to disturbed blood flow (d-flow), while those exposed to stable flow (s-flow) are protected. This study proposes and tests a two-hit hypothesis that d-flow initiates a partial flow-induced reprogramming of endothelial cells (FIRE), whereas full FIRE requires the combined stimuli of d-flow and hypercholesterolemia.
Cardiovasc. Res.2025-12-08