It is well established that atherosclerotic plaques generally develop in low shear stress regions, including curved arterial segments and bifurcations. Once these plaques intrude into the lumen, the shear stress they are exposed to alters with hitherto unknown consequences. We hypothesize that in the more advanced stages of the disease, shear stress has an important impact on plaque composition in such a way that high shear stress enhances plaque vulnerability through its biological impact on the endothelium. We investigated this hypothesis by studying the relationship between shear stress and strain, a marker for plaque composition, in human coronary arteries.Copyright © 2007 by ASME