Author/Editor		Poredoš, Pavel
Title		Endothelial dysfunction in coronary heart disease
Type		članek
Source		In: Pajer Z, Štiblar-Martinčič D, editors. International symposium on cardiovascular diseases. Proceedings of the 29th memorial meeting devoted to prof. dr. Janez Plečnik; 1998 Dec 3-5; Ljubljana. Ljubljana: Medical faculty, Institute of histology and embryology,
Publication year		1998
Volume		str. 33-8
Language		eng
Abstract		The vascular endothelium is an important regulatory organ in maintaining cardiovascular homeostasis. One of the most important vasoactive substances produced by endothelial cells is nitric oxid (NO). In addition to its role in endothelium - derived vasodilation, NO appears to be an endogenous inhibitor of vascular smooth muscle cell proliferation, an inhibitor of platelet and leukocyte adhesion and has an antiinflammatory effect. Endothelial dysfunction, which is predominantly caused by decrease of NO bioactivity, occurs early in the course of atherosclerosis in response to cardiovascular risk factors (hypertension, hyperchlosterolemia, diabetes). Disturbances of the vasomotor function of the epicardial conductane arteries are fundamental abnormalities of coronary blood flow in atherogenesis, and impaired endothelial vasodialtion is the predominant mechanism underlying inappropriate-paradoxical vasocontriction. However, endothelial dysfunction may also extend to the coronary microcirculation. With respect to the clinical presentation of coronary artery disease, endothelial vasodilator dysfunction appears to play a causative role in triggering of myocardial ischemia in stable angina pectoris, to aggravate sequelae of acute ischaemic syndrome and might be the primary underlying mechanism in some patients with syndrome X. It was shown that endothelial dysfunction is a systemic process and that the vasodilator response of the peripheral conduit arteries parallels the vasomotor response of coronary arteries. Thus, noninvasive evaluation of the peripheral arteries is useful in screening patients for the deterous effect of risk factors on the endothelial function of coronary arteries. Further, in this article therapeutic interventions for improvement of the endothelial dysfunction are discussed.
Descriptors		CORONARY DISEASE ENDOTHELIUM, VASCULAR CORONARY VASOSPASM CORONARY ARTERIOSCLEROSIS ENDOTHELIUM-DERIVED RELAXING FACTOR NITRIC OXIDE