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These mimic the layered structure of the native vascular wall, which, from inside out, is composed of the tunica intima, tunica media and tunica adventitia tissues.

The pericardial milk-spots and thickenings, the tendinous or semi-cartilaginous, indurated patches of serous membranes and of the intima of arteries, are all regarded as manifestations of a chronic inflammation of these tissues.

Using in vitro and ex vivo models of vessel wall stiffness and aging, we show that stiffening of extracellular matrix within the intima promotes endothelial cell permeability—a hallmark of atherogenesis.

The whole vascular system, including the heart, has an endothelial lining, which may constitute a distinct inner coat, the tunica intima, or may be without coverings, as in the case of the capillaries.

The internal, serous, or tunica intima, is the thinnest, and is continuous with the lining membrane of the heart.