Int Angiol. 2002 Jun;21(2):109-16. Endothelial dysfunction in the pathogenesis of atherosclerosis.
Poredos P.
Department of Vascular Disease, University Medical Centre, Ljubljana, Slovenia.
pavel.poredos@[email hidden]
A healthy endothelium plays a central role in cardiovascular control. Therefore, endothelial
dysfunction (ED), which is characterized by an imbalance between relaxing and contracting factors,
procoagulant and anticoagulant substances, and between pro-inflammatory and anti-inflammatory
mediators, may play a particularly significant role in the pathogenesis of atherosclerosis. ED is
closely related to different risk factors of atherosclerosis, to their intensity and their duration.
The involvement of risk factors in ED is also supported by results of intervention studies that
showed regression of ED with treatment of risk factors. The common denominator whereby different
risk factors cause ED is most probably increased oxidative stress and/or inflammation. ED promotes
atherosclerosis and probably plays an important role in the development of thrombotic complications
in the late stages of the disease. As ED is a key underlying factor in the atherosclerotic process,
markers of endothelial abnormalities have been sought. Detection of ED is based on tests of endothelium-
dependent vasomotion (dilation capability of peripheral and coronary arteries) and on circulating
markers of endothelial function (endothelin-1, von Willebrand factor, tissue plasminogen activator,
plasminogen activator inhibitor, adhesion molecules). Using these tests it is possible to follow the
dose-response of harmful effects or risk factors, and the effects of preventive procedures on vessel
wall function.
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