Understanding Atherosclerosis

Among the important issues is the necessity to understand that the support of cell metabolism with nutrition and oxygen is only available from the circulatory blood in arteries and capillaries as distributors to the tissue cells. It is not evident that blood flowing through arteries and close to the artery wall contributes oxygen adequately to adjacent artery wall tissue. This is also true of the blood in the chambers of the heart.

There is overwhelming evidence that the blood in the chambers of the heart does not nourish and provide adequate oxygen to the myocardium.

Sub-Clinical Death of Cells The value of this review of the medical research literature has resulted in the discovery of a sub-clinical process of slow death of the functional cells of the vital organs, heart, kidneys, as well as the arterial wall disease, atherosclerosis. There is currently some recognition of a subclinical injury to the heart muscle which is known as “silent ischemia”.

An understanding of this slow but eventually destructive process is based on an understanding of a tissue cell death process which exists as another cell death process and is not to be confused with apoptosis, which is programmed cell death. This other cell death (OCD) is a cell death resulting from cell injury and ends in necrosis. The cell injury is caused by a wide variety of recognized diseases, but the subclinical diseases caused by chronic and sometimes slow cell injury manifest themselves only after the condition has progressed to a level of clinical recognition, or at autopsy. Examples are the diseases of degeneration or weakness of the heart muscles, degeneration of the heart valves, and the various degenerative diseases of the kidneys.

The accumulation of lipids in cells separates the two fundamental cell death processes. The process of programmed cell death is characterized by a shrinking of the cell followed by removal of the dead debris of the cells by phagocytes. This process of apoptosis serves to eliminate cells in a very effective manner to fulfill the purpose of a programmed cell death process. The other cell death process, which is not well-defined in the literature, is a degenerative process which is caused by the respiratory compromise of the tissue cells of the various organs such as heart, kidneys, liver and even the arteries.

It is this poorly understood process which is central to the understanding of the degeneration process discovered by this effort. The death process or “other cell death process” (OCD) has been named oncosis because the first step involves swelling of the cell. However, the word oncosis could easily be confused with its close association with cancer. A more straightforward name would be “cloudy swelling”, which is the first cellular effect recognized by pathologists. The process as observed in the cell historically has been characterized by the light microscope as 1) cloudy swelling; 2) accumulation of fat; and 3) necrosis.

It is important to understand this degenerative process of the cell because it is the key to understanding the degenerative diseases of the vital organs, and even the disease process of atherosclerosis.

The entire book “When Cells Die” is devoted to the explanation of and the significance of apoptosis (5). However in chapter two, Benjamin F. Trump and Irene K. 5