The enigma of the endothelium

The endothelium was earlier regarded as a relatively inert layer performing rather simple physiological functions. However extensive research has recently revealed that the endothelial layer performs a vast array of functions such as maintenance of vascular tone, control over coagulation and fibrinolysis besides a lot of chemical interactions. More recently, endothelial dysfunction has been implicated as important in the pathogenesis of atherosclerosis, coronary artery disease, myocardial ischemia and post-intervention restenosis. The demonstration that endothelial dysfunction may be reversible by employing various strategies raises the possibility of retarding the progress or even preventing the process of atherosclerosis thereby reducing the risk of acute cardiovascular events.