title: Normal and pathophysiologic considerations of endothelial regulation of vascular tone and their relevance to nitrate therapy.
abstract: During the past decade, it has become clear that the vascular endothelium critically influences vascular permeability, controls vessel growth, modulates hemostasis, and regulates vasomotion. This latter role of the endothelium is mediated by the liberation of a number of potent vasoactive compounds, including endothelium-derived relaxing factors, one of which is either nitric oxide or a compound that releases nitric oxide, vasoactive prostaglandins, hyperpolarizing factors, and a number of constricting factors. This role of the endothelium is dramatically altered by several diseases, including atherosclerosis, hypertension, and diabetes. Abnormalities of endothelial regulation of vascular tone may contribute to a number of clinical syndromes, including variant angina, unstable angina, syndrome X, and perhaps many others. In this review, several aspects of the endothelium-derived relaxing factor will be considered, including recent concepts regarding its synthesis, its chemical identity, and alterations in atherosclerosis. Finally, its action in the coronary microcirculation as contrasted to that of nitroglycerin will be considered.
authors.affiliation: Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: D G
authors.initials: DG
authors.lastname: Harrison
authors.forename: M A
authors.initials: MA
authors.lastname: Kurz
authors.forename: J E
authors.initials: JE
authors.lastname: Quillen
authors.forename: F W
authors.initials: FW
authors.lastname: Sellke
authors.forename: A
authors.initials: A
authors.lastname: Mügge
mesh_terms: D000818:Animals; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology*; D009129:Muscle Tonus / Q000187:drug effects* / Q000502:physiology; D009131:Muscle, Smooth, Vascular / Q000187:drug effects / Q000502:physiology*; D009569:Nitric Oxide / Q000502:physiology*; D005996:Nitroglycerin / Q000627:therapeutic use*; D012016:Reference Values; D014652:Vascular Diseases / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D009569:Nitric Oxide; D005996:Nitroglycerin