Endothelial Dysfunction and Coronary Vasoreactivity - a review of the history, physiology, diagnostic techniques and clinical relevance

Gunawardena, Tharusha, Merinopoulos, Ioannis, Wickramarachchi, Upul, Vassiliou, Vassilios and Eccleshall, Simon (2020) Endothelial Dysfunction and Coronary Vasoreactivity - a review of the history, physiology, diagnostic techniques and clinical relevance. Current Cardiology Reviews. 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 a 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 consider exploring the narrative of the coronary circulation as more than just a simple conduit for blood but an organ with functional significance. We discuss the organisation and physiology of the coronary circulation as well as the current methods and techniques used to examine it. We then review 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. We conclude that greater recognition of the coronary artery endothelium and mechanisms of the coronary circulation should guide revascularisation strategies further.

Item Type: Article
Additional Information: Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.
Faculty \ School:
Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 02 Jul 2020 23:59
Last Modified: 14 Oct 2020 23:56
URI: https://ueaeprints.uea.ac.uk/id/eprint/75886
DOI: 10.2174/1573403X16666200618161942

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