CORONARY ENDOTHELIAL DYSFUNCTION IN THE HYPERTENSIVE PATIENT - FROM MYOCARDIAL-ISCHEMIA TO HEART-FAILURE

The endothelium modulates vascular tone by the release of vasodilator and vasoconstrictor substances, among them nitric oxide (NO) and endot helin (ET). Abnormalities in NO generation have been demonstrated in v arious cardiac pathophysiological states, specifically atherosclerotic vascular disease, congestive heart failure, and essential and pulmona ry hypertension, Moreover, increases in plasma ET has been reported as well in these disease states, When these observations are taken toget her, these states may be characterized by an attenuated release of NO, whereas the release of ET is augmented, An imbalance between NO and E T may contribute to the alteration in vascular tone characteristic of cardiovascular disease, The following review summarizes the present kn owledge of the role of NO and ET in such disease processes with a majo r focus on coronary endothelial dysfunction.