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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 ]
VEGFR-2 is a 210-230 kDa glycoprotein expressed in vascular endothelial cells and in hematopoietic stem cells and binds VEGF-A. [2] [4] VEGFR-2 is closely related to VEGFR-1 for they have common and specific ligands but VEGFR-2 is a highly active kinase while VEGFR1 is an impaired receptor tyrosine kinase.
Endothelial dysfunction has also been shown to be predictive of future adverse cardiovascular events including stroke, heart disease, and is also present in inflammatory disease such as rheumatoid arthritis, diabetes, and systemic lupus erythematosus. [18] [19] Endothelial dysfunction is a result of changes in endothelial function.
An insulin-sensitizing medication called rosiglitazone is known to treat endothelial dysfunction. It has been demonstrated that this medication reduces renal end-organ damage in patients with type 2 diabetes and microalbuminuria , improves nitric oxide bioavailability, and ameliorates glomerular hyperfiltration in patients with early type 2 ...
Endothelium dysfunction is a prototypical characteristic of vascular disease, which is common in patients with autoimmune diseases such as systemic lupus erythematosus. [20] Further, there is an inverse relationship between age and levels of EPCs. Inverse of endothelial dysfunction also occurs when other risk factors are treated. [21]
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]
The chronic endothelial injury hypothesis is one of two major mechanisms postulated to explain the underlying cause of atherosclerosis and coronary heart disease (CHD), the other being the lipid hypothesis. Although an ongoing debate involving connection between dietary lipids and CHD sometimes portrays the two hypotheses as being opposed, they ...
The treatment consists of drugs, mainly to relieve chest pain, but a very important part of the treatment is regularly visiting the doctor and repeating the tests to make sure the condition was taken care of in full. The first step in managing Microvascular angina is the administration of nitrates which may relieve the chest pain. They are used ...