Cited by 249Cardiovascular Health and Disease PreventionNitric Oxide and Endothelin EffectsCardiac Imaging and Diagnostics

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Endothelial dysfunction and coronary artery disease: assessment, prognosis, and treatment

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Matsuzawa, Yasushi, Lerman, Amir·2014·Coronary Artery Disease

DOI 10.1097/mca.0000000000000178PMC PMC4220301

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Abstract

Progress in the modification of conventional coronary risk factors and lifestyle behavior has reduced the incidence of atherosclerotic coronary artery disease; nonetheless, it continues to be the leading cause of mortality in the world. This might be attributed to the defective risk stratifying and prevention strategy for coronary artery disease. In the current clinical setting, atherosclerotic coronary artery disease risk is estimated on the basis of identifying and quantifying only traditional risk factors; it does not take into consideration nontraditional risk factors. In addition, most of the prevailing therapies for atherosclerosis are targeted toward traditional risk factors rather than atherosclerosis itself. It is desirable to develop a method that can directly assess the activity of atherogenesis at every moment. Endothelial function is an integrated index of all atherogenic and atheroprotective factors present in an individual including nontraditional factors and heretofore unknown factors, and it is reported to have additional predictive value for future cardiovascular events to traditional risk factors. Moreover, endothelial function has a pivotal role in all phases of atherosclerosis, from initiation to atherothrombotic complication, and is reversible at every phase, indicating that endothelial function-guided therapies might be effective and feasible in cardiovascular practice. Thus, the introduction of endothelial function testing into clinical practice might enable us to innovate individualized cardiovascular medicine. In this review, we summarize the current knowledge on the contribution of endothelial dysfunction to atherogenesis and review the methods that assess endothelial function. Finally, we focus on the effects of major antiatherosclerotic disease therapies on endothelial function and argue the possibility of noninvasive assessment of endothelial function aiming at individualized cardiovascular medicine.

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Authors: Matsuzawa, Y., & Lerman, A.
Affiliations: Mayo Clinic (US)
Corresponding author: Lerman, Amir
ORCID: Matsuzawa, Yasushi
Lerman, Amir
Venue: Coronary Artery Disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-12
Volume: 25
Issue: 8
Pages: 713-724
ISSN: 0954-6928 (ISSN-L)
DOI: 10.1097/mca.0000000000000178
PMC: PMC4220301
OpenAlex: W2081776702
Cited by: 249
References: 88
Citations by year: 2026: 10 · 2025: 23 · 2024: 18 · 2023: 24 · 2022: 25 · 2021: 29 · 2020: 39 · 2019: 24 · 2018: 22 · 2017: 11 · 2016: 10 · 2015: 13
FWCI: 1.83
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Coronary Artery Disease (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Aging (AG31750, R01AG031750)
National Heart, Lung, and Blood Institute (HL92954, R01HL092954)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Keywords: endothelial dysfunction, endothelial function testing, atherosclerosis, atherogenesis, non-traditional risk factors, cardiovascular risk stratification, antiatherosclerotic therapy, atherothrombosis, cardiovascular risk prediction
MeSH terms: Animals, Coronary Artery Disease, Diagnostic Techniques, Cardiovascular, Endothelium, Vascular, Humans, Predictive Value of Tests, Prognosis, Risk Factors, Risk Assessment

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