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Endothelial dysfunction may be involved in the development of atherosclerosis [5] [6] [7] and may predate vascular pathology. [ 5 ] [ 8 ] Endothelial dysfunction may also lead to increased adherence of monocytes and macrophages , as well as promoting infiltration of low-density lipoprotein (LDL) in the vessel wall. [ 9 ]
Microangiopathy (also known as microvascular disease, small vessel disease (SVD) or microvascular dysfunction) is a disease of the microvessels, small blood vessels in the microcirculation. [1] It can be contrasted to macroangiopathies such as atherosclerosis , where large and medium-sized arteries (e.g., aorta , carotid and coronary arteries ...
This endothelial dysfunction leads to impaired myocardial blood flow reserve as evidence by echocardiography. [10] About 50% of diabetics with diabetic cardiomyopathy show pathologic evidence for microangiopathy such as sub-endothelial and endothelial fibrosis, compared to only 21% of non-diabetic heart failure patients. [11]
Microvascular angina (MVA), previously known as cardiac syndrome X, [1] also known as coronary microvascular dysfunction (CMD) or microvascular coronary disease is a type of angina (chest pain) with signs associated with decreased blood flow to heart tissue but with normal coronary arteries. [2] [3]
The primary cause of microvascular angina is unknown, but factors apparently involved are endothelial dysfunction and reduced flow (perhaps due to spasm) in the tiny "resistance" blood vessels of the heart. [18] Since microvascular angina is not characterized by major arterial blockages, it is harder to recognize and diagnose. [19] [20] [21]
Endothelial dysfunction is a result of changes in endothelial function. [ 20 ] [ 21 ] After fat ( lipid ) accumulation and when stimulated by inflammation, endothelial cells become activated, which is characterized by the expression of molecules such as E-selectin, VCAM-1 and ICAM-1, which stimulate the adhesion of immune cells. [ 22 ]
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Vascular disease is a pathological state of large and medium muscular arteries and is triggered by endothelial cell dysfunction. [22] Because of factors like pathogens, oxidized LDL particles and other inflammatory stimuli endothelial cells become active. [23]