Abstract
The endothelium plays an important role in maintaining vascular homeostasis and regulating blood vessel function. Endothelial function is considered an independent predictor for risk of future cardiovascular events in cardiovascular and non-cardiovascular patients, as well as a predictor for postoperative complications in cardiovascular surgery patients. Brachial artery flow-mediated dilation by high-resolution ultrasound is widely used to evaluate endothelium-dependent vasodilation, which is mainly mediated by nitric oxide release. Physical exercise exerts beneficial effects on endothelial function and can be used in both primary and secondary prevention of cardiac and peripheral artery diseases, even in the postoperative period of cardiovascular surgery.
Highlights
The Role of the Endothelium in Regulating Vascular HealthThe endothelium is the first line of defense of endorgans against external aggression and plays an important role in maintaining vascular homeostasis[1]
The results demonstrated that the patients with significant (≥ 50%) coronary artery stenosis had lower Flow-mediated dilation (FMD) and higher intima-media thickness (IMT) values compared to patients without significant coronary artery disease (CAD)
The results showed that FMD significantly differed between event-free survivors or death in 75 CHF patients with left ventricular ejection fraction (LVEF) ≤ 30%, FMD values were significantly impaired in CHF patients who reached the combined endpoint as compared with CHF survivors (5.4±5.1% vs. 11.2±7.4%)
Summary
The endothelium is the first line of defense of endorgans against external aggression and plays an important role in maintaining vascular homeostasis[1]. NO has been shown to play an important role in the maintenance of basal vasodilator tone of the blood vessels and plays a key role in vasodilation[4] It prevents platelet adhesion and aggregation, as well as leukocyte adhesion and migration into the arterial wall and inhibits smooth muscle cell proliferation and intimal migration, oxidation of LDL cholesterol, apoptosis of smooth muscle cells, all key events in the development of atherosclerosis[2]. Flow-mediated dilation (FMD) is a physiologically important stimulus regulating vascular tone and homeostasis of the peripheral circulation. This important endothelial mechanism of vasodilation occurs in virtually every vascular bed. ROS might interact with NO and reduce its bioavailability via different pathways: direct NO inactivation by superoxide with peroxynitrite (ONOO–) formation; reduction in NO synthase expression and activity due to changes in their substrate or cofactors, and endothelial NOS uncoupling[9]
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