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. Author manuscript; available in PMC: 2019 Feb 20.
Published in final edited form as: Heart. 2018 May 15;104(20):1647–1653. doi: 10.1136/heartjnl-2017-312123

Figure 2.

Figure 2

Mechanism of radiation-induced coronary injury. The intima of the healthy vessel is thin, and its collagenous component is well organized, as in frame (A). In the hours after radiation exposure, the endothelium becomes effaced, permitting chemotaxis of macrophages into the intima, where they begin to secrete profibrotic chemokines such as TGF-beta (B). This results in the terminal differentiation of SMCs into myofibroblasts, which enter the intima, where they generate large quantities of type IV collagen (C). The result is a state of chronic fibrosis and progressive stenosis (D), occurring over the months and years after. SMC, smooth muscle cell; TGF, transforming growth factor.