Endothelial dysfunction and coronary vasoreactivity - a review of the history, physiology, diagnostic techniques and clinical relevance

Gunawardena, Tharusha, Merinopoulos, Ioannis, Wickramarachchi, Upul, Vassiliou, Vassilios ORCID: https://orcid.org/0000-0002-4005-7752 and Eccleshall, Simon (2021) Endothelial dysfunction and coronary vasoreactivity - a review of the history, physiology, diagnostic techniques and clinical relevance. Current Cardiology Reviews, 17 (1). pp. 85-100. ISSN 1573-403X

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Abstract

The fervency for advancement and evolution in percutaneous coronary intervention has revolutionised the treatment of coronary artery disease. Historically, the focus of the interventional cardiologist was directed at the restoration of luminal patency of the major epicardial coronary arteries, yet whilst this approach is evolving with much greater utilisation of physiological assessment, it often neglects consideration of the role of the coronary microcirculation, which has been shown to clearly influence prognosis. In this review, we explore the narrative of the coronary circulation as more than just a simple conduit for blood but an organ with functional significance. We review organisation and physiology of the coronary circulation, as well as the current methods and techniques used to examine it. We discuss the studies exploring coronary artery endothelial function, appreciating that coronary artery disease occurs on a spectrum of disorder and that percutaneous coronary intervention has a latent effect on the coronary circulation with long-term consequences. It is concluded that greater recognition of the coronary artery endothelium and mechanisms of the coronary circulation should further guide revascularisation strategies.

Item Type: Article
Uncontrolled Keywords: acute coronary syndrome,angina,bioresorbable scaffolds,coronary microcirculation,drug coated balloons,drug eluting stents,endothelial function,minoca,microvascular angina,vasomotion,vasoreactivity testing,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2705
Faculty \ School:
Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 02 Jul 2020 23:59
Last Modified: 17 Dec 2024 01:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/75886
DOI: 10.2174/1573403X16666200618161942

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