In the present study ranging from in vitro cell culture studies on effects of disturbed flow on molecular signaling to in vivo investigations on clinical specimens from patients with coronary artery disease (CAD), we investigated the roles of integrins and different ECMs, including FN and LM, in TGFβ receptor-mediated Smad2 activation and NF-κB signaling in ECs in response to disturbed flow. The gene discussed is SMAD2; the disease is coronary artery disorder.