ENDOTHELIAL DYSFUNCTION IN ISCHEMIC HEART DISEASES

Abstract

Aim. To assess the role of disorders of vasodilating, vasoconstrictor and adhesive functions of the endothelium in the development of angina pectoris in patients with ischemic disease heart (CHD). Material and methods. 93 patients with coronary heart disease were examined, 35 of them with functional class II (FC) angina pectoris, 30 with FC III, 28 with FC IV. The control group consisted of 23 healthy individuals. Bicycle ergometry, 24-hour ECG monitoring, and echocardiography were used to verify IHD. The vasodilating function of the endothelium was assessed by endothelium-dependent (EDVD) and endothelium-independent vasodilation (EIDVD) of the brachial artery; vasoconstrictor function - by the level of endothelin-1 (ET-1). The adhesive function of the endothelium was judged by the concentration of intercellular adhesion molecules JCAM-1, VCAM-1, and E-selectin. Results. With angina pectoris II FC, the indicators of EDVD and EIDVD, the level of ET-1 and the content of intercellular molecules adhesions were within the normal range. As the FC of angina pectoris increased, the vasodilating function of the endothelium was inhibited, and the production of ET-1 and intercellular adhesion molecules increased. FC IV angina was characterized by overexpression of JCAM-1, VCAM-1, E-selectin, excessive secretion of ET-1 at low levels of EDVD and EIDVD. Conclusion. The clinical course of coronary artery disease is associated with impaired vasodilating, vasoconstrictor and adhesive functions endothelium.