Endothelial cells (ECs) on blood vessel walls are exposed to both the wall shear stress (WSS) of blood flow and the cyclic circumferential strain (CS) of the pulsing vessel wall. The WSS and CS are both oscillatory and approximately perpendicular to each other in their direction of action. Due to wave reflection in the circulation and inertial effects in blood flow, WSS is not always in phase with CS. The interaction of CS and WSS generates a complex, time varying mechanical force pattern applied to the EC layer, which is believed to play a role in determining EC biological response, remodeling of blood vessels, and possibly development of arterial disease. The stress phase angle (SPA) between CS and WSS, which characterizes the dynamic force pattern on ECs, varies throughout the circulation as discussed in this paper.

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