The role of coronary endothelial function testing in patients suspected for angina pectoris.
Coronary vasomotor function plays an important role in onset and progression of coronary artery disease. Suwaidi [Circulation 101 (2000) 948] and Schächinger [Circulation 101 (2000) 1899] demonstrated that vasomotor dysfunction has a significant impact on events in patients with minimal coronary artery disease. Endothelial specific testing can be performed in coronary as well as peripheral arteries. However, non-coronary tests have a low correlation with the coronary vasomotor response, as assessed by acetylcholine. In large clinical prospective placebo-controlled trials, angiotensin-converting enzyme (ACE) inhibitors and lipid-lowering drugs reduce morbidity and mortality after myocardial infarction or myocardial infarction-induced heart failure. The same drugs restore endothelial dysfunction after myocardial infarction, as was demonstrated in small experimental and clinical studies. Recent studies in patients with coronary artery disease showed a relation with endothelial dysfunction and the occurrence of adverse coronary events. For this reason, it is important to develop methods to evaluate endothelial function.
Monnink
S H J
SH
Department of Cardiology, Thoraxcentre, University Hospital Groningen, Groningen, The Netherlands. smonnick@hetnet.nl
Tio
R A
RA
van Boven
A J
AJ
van Gilst
W H
WH
van Veldhuisen
D J
DJ
D000787:Angina Pectoris / Q000473:pathology / Q000517:prevention & control*; D000792:Angiography; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000473:pathology / Q000517:prevention & control*; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D014666:Vasomotor System / Q000187:drug effects / Q000503:physiopathology*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000960:Hypolipidemic Agents