Morphologic and pathogenetic aspects of coronary artery atherosclerosis in ischemic heart disease.

The surface of coronary arteries is subjected to pronounced changes in all stages of atherogenesis. Structural and functional re-arrangements within the endothelial cell monolayer reflect one or another degree of manifestation of defensive or adaptative reactions in the course of pathogenesis. The formation of crater-like defects and monocyte adhesions is a constant and characteristic feature of initial stages of atherosclerosis. Focal formation of microthrombi can be observed in initial stages of atherogenesis. Endothelium impairment and its regeneration occur at all stages of atherogenesis. Macrophages of monocyte origin play a key role in the formation of foam cells.