Coronary Artery Disease and Endothelial Dysfunction: Novel Diagnostic and Therapeutic Approaches

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Pathophysiology

Background:

• Coronary artery disease (CAD) is a major global health burden, primarily driven by atherosclerosis.
• Atherosclerosis is a chronic inflammatory process beginning in childhood, with endothelial dysfunction playing a key role in its initiation and progression.
• Endothelial dysfunction, characterized by reduced nitric oxide bioavailability, is a critical factor in cardiovascular disease development and prognosis.

Purpose of the Study:

• To review current knowledge on the evaluation of endothelial function in the context of acute coronary syndromes (ACS) and stable coronary artery disease (CAD).
• To summarize existing and emerging therapeutic approaches targeting endothelial dysfunction.
• To highlight the clinical significance of endothelial function assessment in cardiovascular medicine.

Main Methods:

• Review of existing literature on endothelial function assessment techniques.
• Discussion of non-invasive methods like ultrasound-based flow-mediated dilation (FMD) of the brachial artery.
• Explanation of invasive methods, including intracoronary administration of vasoactive agents for direct coronary assessment.

Main Results:

• Endothelial dysfunction is a significant predictor of poor cardiovascular outcomes.
• Various methods exist for evaluating endothelial function, ranging from peripheral non-invasive tests to direct coronary assessments.
• Therapeutic interventions targeting endothelial dysfunction are crucial for managing cardiovascular disease.

Conclusions:

• Accurate assessment of endothelial function is vital for understanding atherosclerosis and CAD progression.
• Targeting endothelial dysfunction offers a promising therapeutic avenue for improving cardiovascular health.
• This review provides a comprehensive overview of diagnostic and therapeutic strategies for endothelial dysfunction in CAD.