Circulation. 2002;105:546-549
doi: 10.1161/hc0502.104540
doi: 10.1161/hc0502.104540
(Circulation. 2002;105:546.)
© 2002 American Heart Association, Inc.
Clinician Update |
Fundamentals of Endothelial Function for the Clinical Cardiologist
From the Division of Cardiac Surgery, University of Toronto (S.V.), and the Division of Cardiology, University of Calgary (T.J.A.), Canada.
Correspondence to Subodh Verma, MD, PhD, 14 EN-217, 200 Elizabeth St, Toronto General Hospital, Toronto, Ontario, Canada, M5G 2C4. E-mail subodh.verma@sympatico.ca
Key Words: endothelium • cardiovascular diseases • physiology
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Introduction |
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Case presentation 1: Mr Gundry is a 42-year-old construction worker who has had type II diabetes mellitus for the past 6 years. He has no other vascular risk factors and is currently asymptomatic. Is this patient at risk of developing endothelial dysfunction?
Case presentation 2: Mr Sinha is a 64-year-old man who presents to your office for symptomatic intermittent claudication. Past medical history is unremarkable except for the presence of multiple vascular risk factors (smoking, hypertension, dyslipidemia, and obesity). How do vascular risk factors cause endothelial dysfunction? Is endothelial dysfunction treatable?
A survey of medical history will reveal that major breakthroughs are often a result of simple and at times unexpected observations. Indeed, the era of endothelial biology was brought to the forefront through a simple pharmacological experiment conducted approximately 2 decades ago in Dr Furchgott’s laboratory.1 In this landmark study, the authors described the essential role of the endothelium in mediating the vasodilatory actions of acetylcholine, now known to be dependent on the release of nitric oxide (NO) from the endothelium. No one could have predicted that this observation would have the gargantuan impact on vascular biology that is evident today. Endothelial dysfunction now is implicated in the pathogenesis and clinical course of the majority of cardiovascular diseases. The purpose of this "Clinical Cardiology: Physician Update" is to provide the busy cardiovascular specialist with some of the fundamental principles of endothelial function as they relate to cardiovascular health and disease.
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How Does the Endothelium Maintain Vascular Homeostasis? |
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The endothelium is a single-cell lining covering the internal
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