Abstract
The term endothelial dysfunction most commonly refers to impairment of endothelium-dependent vasodilation and implies
presence of widespread abnormalities in endothelial integrity and homeostasis. This
phenomenon, which can be measured by a number of invasive and noninvasive techniques,
often marks an early stage in atherosclerosis and can be observed in coronary and
peripheral arterial beds. Studies demonstrate that endothelial dysfunction in the
coronary resistance or conductance vessels predict both hard (eg, acute ischemic events)
and soft (eg, coronary revascularization) outcomes. Other studies demonstrate that
endothelial dysfunction of the brachial artery also carries prognostic relevance for
risk of coronary events. However, these studies included selected high-risk populations.
Data are lacking on the prognostic value of endothelial dysfunction in low-risk populations.
Further, the data do not permit the use of improvement in endothelial dysfunction
as a surrogate marker for risk reduction. Nevertheless, assessment of endothelial
function is a valuable research tool and, with further refinement, promises to be
an important aid in applying the science of vascular biology to clinical practice.
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© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
