Disturbed flow (d-flow) (d-flow)

Disturbed flow (d-flow) refers to a hemodynamic state characterized by low and oscillatory wall shear stress, typically occurring at arterial branch points, bifurcations, and curvatures. Unlike steady laminar flow, which is atheroprotective, disturbed flow induces a pro-inflammatory and pro-thrombotic phenotype in the vascular endothelium, making these sites highly susceptible to the development of atherosclerotic plaques. Mechanotransduction at these sites involves various sensors, including Piezo1 ion channels, PECAM-1, and G protein-coupled receptors, which convert mechanical forces into biochemical signals like NF-kB activation. While not a single molecule or receptor itself, disturbed flow sites represent a localized physiological environment that is a primary driver of cardiovascular pathology. Therapeutic strategies often focus on modulating the molecular pathways activated at these sites, such as upregulating protective transcription factors like Kruppel-like factor 2 (KLF2) or inhibiting mechanosensitive microRNAs and inflammatory cascades.

Other names

Oscillatory shear stressLow shear stressNon-laminar flowRecirculating flowAtheroprone flow

Modulation of mechanosensitive signaling pathways, such as inhibition of Piezo1 or activation of Nrf2 and KLF2 to counteract pro-inflammatory endothelial activation induced by non-laminar shear stress.