Flow-dependent remodeling of small arteries: the stimuli and the sensors are (still) in question.

From the embryonic state to the end of life, the elements of the circulatory system are exposed to hemodynamic forces associated with the circulation of blood. Various levels of intraluminal (transmural) pressure and wall shear stress represent the natural environment for the tissues of the vascular wall. Physiological or pathological changes in the level of these forces elicit active responses in the cellular and noncellular elements of the vascular wall. In the short-term, vessels may change their functional diameter, whereas, if the hemodynamic forces are altered chronically, this results in morphological changes of the wall, indicated by changes in vessel diameter and wall thickness, frequently termed remodeling, aimed at minimizing the effect of altered hemodynamic forces on the vascular wall.