ELN and endothelial dysfunction: They are associated with structural (e.g., VSMC proliferation, remodeling of the ECM, increased collagen deposition, collagen crosslinking, and elastin fragmentation) and functional (e.g., VSMC phenotype switching, proinflammatory signaling, endothelial dysfunction, and PVAT dysfunction) vascular wall changes (Fig. 2b, d).