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Endothelial Dysfunction and Coronary Artery Disease

A State of the Art Review

Veerasamy, Murugapathy MBBS, MRCP*†; Bagnall, Alan MB ChB, PhD, FRCP*†; Neely, Dermot BSc, MD, FRCP, FRCPath; Allen, John PhD, CSci, CEng, MIPEM, MIET; Sinclair, Hannah MB ChB, MRCP*†; Kunadian, Vijay MBBS, MD, FRCP*†

doi: 10.1097/CRD.0000000000000047
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Atherosclerotic coronary artery disease (CAD) is a major cause of morbidity and mortality in the developed world. Endothelial dysfunction plays an important role in the development of atherosclerosis and predicts cardiovascular (CV) outcomes independent of conventional CV risk factors. In recent years, there have been tremendous improvements in the pharmacological prevention and management of CAD. In this review, the pathophysiology of endothelial dysfunction in relation to CAD is discussed and various techniques of invasive and noninvasive assessments of peripheral and coronary endothelial function described. In addition, evidence for the association of endothelial dysfunction and CV outcomes has been examined and finally the role of therapeutic interventions in endothelial dysfunction has been discussed.

From the *Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, United Kingdom; Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom; Department of Biochemistry, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom; and §Regional Medical Physics Department, Freeman Hospital, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom.

Disclosure: None of the authors have any conflict of interest to disclose.

Correspondence: Vijay Kunadian, MBBS, MD, FRCP, FACC, FESC, Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, 3rd Floor William Leech Building, Newcastle-upon-Tyne, NE2 4HH, United Kingdom. E-mail: vijay.kunadian@newcastle.ac.uk.

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