TY - JOUR
T1 - The endothelium
T2 - Dysfunction and beyond
AU - Herrmann, J.
AU - Lerman, A.
N1 - Funding Information:
From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn. This work was supported in part by the Mayo Foundation and the Ruth and Bruce Rappaport Vascular Biology Program. Reprint requests: Amir Lerman, MD, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905; lerman.amir@mayo.edu. Copyright © 2001 by the American Society of Nuclear Cardiology. 1071-3581/2001/$35.00 + 0 43/1/114148 doi:10.1067/mnc.2001.114148
PY - 2001
Y1 - 2001
N2 - Since its anatomic discovery in the 19th century, the endothelium was considered to fulfill no other purpose than that of a physical barrier between blood and tissue, until Furchgott and colleagues defined endothelium-dependent vasoreactivity in the late 1970s. Henceforth, a functional paradigm defined the balance between endothelium-derived relaxing factors and endothelium-derived contracting factors as the hallmark of endothelial cell integrity. As a consequence, any reflection of a deviation from this state was defined as endothelial dysfunction, most notably the impairment of vasorelaxation in response to pharmacologic stimuli such as acetylcholine or nonpharmacologic stimuli such as shear stress and cold pressor. Within the coronary artery tree these alterations have been recognized before the development of obstructive coronary artery disease, affecting the microcirculation before the epicardial conduit vessel. Furthermore, recent clinical trials outlined the prognostic significance of these changes, whereby impairment of increase in coronary blood flow in response to endothelium-dependent stimuli seemed to be of utmost importance. Thus it is intriguing to speculate on the evolving role of myocardial perfusion imaging in combination with pharmacologic and nonpharmacologic stimuli for the noninvasive assessment of coronary endothelial dysfunction in patients at risk for future adverse events. At a minimum, this review aims to put endothelial dysfunction into an imaging perspective beyond the scope of the conventional approach.
AB - Since its anatomic discovery in the 19th century, the endothelium was considered to fulfill no other purpose than that of a physical barrier between blood and tissue, until Furchgott and colleagues defined endothelium-dependent vasoreactivity in the late 1970s. Henceforth, a functional paradigm defined the balance between endothelium-derived relaxing factors and endothelium-derived contracting factors as the hallmark of endothelial cell integrity. As a consequence, any reflection of a deviation from this state was defined as endothelial dysfunction, most notably the impairment of vasorelaxation in response to pharmacologic stimuli such as acetylcholine or nonpharmacologic stimuli such as shear stress and cold pressor. Within the coronary artery tree these alterations have been recognized before the development of obstructive coronary artery disease, affecting the microcirculation before the epicardial conduit vessel. Furthermore, recent clinical trials outlined the prognostic significance of these changes, whereby impairment of increase in coronary blood flow in response to endothelium-dependent stimuli seemed to be of utmost importance. Thus it is intriguing to speculate on the evolving role of myocardial perfusion imaging in combination with pharmacologic and nonpharmacologic stimuli for the noninvasive assessment of coronary endothelial dysfunction in patients at risk for future adverse events. At a minimum, this review aims to put endothelial dysfunction into an imaging perspective beyond the scope of the conventional approach.
KW - Atherosclerosis
KW - Endothelial dysfunction
KW - Imaging techniques
KW - Myocardial perfusion
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U2 - 10.1067/mnc.2001.114148
DO - 10.1067/mnc.2001.114148
M3 - Article
C2 - 11295698
AN - SCOPUS:0035050441
SN - 1071-3581
VL - 8
SP - 197
EP - 206
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 2
ER -