Endothelial cells in vivo are believed to adapt to local hemodynamics in regions with largely unidirectional flow  and develop a quiescent phenotype. However, the local shear stress is altered occasionally by changes in global hemodynamic variables, such as heart rate and flow rate. These changes are caused by a number of normal physiologic events, such as exercise, smoking, sleep, stress and digestion. The duration of these changes ranges from minutes to hours, and endothelial cells undergo structural remodeling and phenotypic transformation in order to adapt to the altered shear stress. During the adaptive response, the dynamics of endothelial phenotypic change adds a new dimension to the endothelial response to shear stress.
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Gene Expression Profiles of Arterial Endothelial Cells in Response to Increased Shear Stress
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Zhang, J, Burridge, KA, & Friedman, MH. "Gene Expression Profiles of Arterial Endothelial Cells in Response to Increased Shear Stress In Vivo." Proceedings of the ASME 2010 Summer Bioengineering Conference. ASME 2010 Summer Bioengineering Conference, Parts A and B. Naples, Florida, USA. June 16–19, 2010. pp. 27-28. ASME. https://doi.org/10.1115/SBC2010-19196
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