Endothelial dysfunction: does it matter? Is it reversible? J Am Coll Cardiol.
The pathogenesis of atherosclerosis: a perspective for the 1990s. Hypertension and left ventricular hypertrophy are associated with impaired endothelium-mediated relaxation in human coronary resistance vessels. 6 Treasure CB, Klein L, Vita JA, Manoukian SV, Renwick GH, Selwyn AP, Ganz P, Alexander W.Effects of age on endothelium-dependent vasodilation of resistance coronary artery by acetylcholine in humans. 5 Egashira K, Inou T, Hirooka Y, Kai H, Sugimachi M, Suzuki S, Kuga T, Urabe Y, Takeshita A.Evidence that selective endothelial dysfunction may occur in the absence of angiographic or ultrasound atherosclerosis in patients with risk factors for atherosclerosis. 4 Reddy KG, Nair RN, Sheehan HM, Hodgson JM.Coronary vasomotor response to acetylcholine relates to risk factors for coronary artery disease. 3 Vita JA, Traesure CB, Nable EG, Mclenachan JM, Fish RD, Yeung AC, Vekshtein VI, Selwyn AP, Ganz P.Impaired coronary blood flow response to acetylcholine in patients with coronary risk factors and proximal atherosclerotic lesions. 2 Egashira K, Inou T, Yamada A, Hirooka Y, Marouka Y, Takeshita A.Hyperlipidemia, hypertension, and coronary heart disease. This study supports the concept that coronary endothelial dysfunction may play a role in the progression of coronary atherosclerosis. Cardiac events included myocardial infarction, percutaneous or surgical coronary revascularization, and/or cardiac death.Ĭonclusions-Severe endothelial dysfunction in the absence of obstructive coronary artery disease is associated with increased cardiac events. However, 6 (14%) with severe endothelial dysfunction had 10 cardiac events ( P<0.05 versus groups 1 and 2). Over an average 28-month follow-up (range, 11 to 52 months), none of the patients from group 1 or 2 had cardiac events. Patients were divided on the basis of their response to acetylcholine into 3 groups: group 1 (n=83), patients with normal endothelial function group 2 (n=32), patients with mild endothelial dysfunction and group 3 (n=42), patients with severe endothelial dysfunction. Methods and Results-Follow-up was obtained in 157 patients with mildly diseased coronary arteries who had undergone coronary vascular reactivity evaluation by graded administration of intracoronary acetylcholine, adenosine, and nitroglycerin and intracoronary ultrasound at the time of diagnostic study. Thus, this study was designed to evaluate the outcome of patients with mild coronary artery disease on the basis of their endothelial function. Although endothelial dysfunction is considered an early phase of coronary atherosclerosis, there is a paucity of information regarding the outcome of these patients. Customer Service and Ordering Informationīackground-Coronary endothelial dysfunction is characterized by vasoconstrictive response to the endothelium-dependent vasodilator acetylcholine.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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