RESUMO
Endothelial dysfunction is a systemic disorder and a key variable in the pathogenesis of atherosclerosis and its complications. Current evidence suggests that endothelial status is not determined solely by the individual risk factor burden but rather, an integrated index of all atherogenic and atheroprotective factors present in an individual, including known as well as yet-unknown variables and genetic predisposition. The aim of the present study is to examine the relation of impaired endothelial dependent dilatation of the brachial artery which is a sensitive marker of endothelial dysfunction and occurs early during development of atherosclerosis with stable and unstable angina pectoris. One of those new techniques is assessment of the peripheral vascular endothelial function testing as a non invasive indicator of coronary artery disease using brachial artery ultrasound. This study was carried out in Zagazig University hospitals, and included 120 patients divided into three groups; group I: chronic stable angina pectoris, group II: unstable angina pectoris and group III: control group. All the results were analyzed statistically to detect their significance. The study showed that there was a significant correlation between the FMD and the results of the coronary angiography and both systolic and diastolic functions of the cit ventricle. It also showed significant correlations between the brachial artery flow-mediated dilation of the brachial artery and most of the cardiovascular risk factors. The results support the notion that evaluation of peripheral vascular endothelial function can accurately exclude CAD in subjects undergoing noninvasive assessment for atherosclerosis. Determination of peripheral endothehial function can confirm a low probability of CAD in low-risk individuals and, thus, may obviate the need for more elaborate testing. Systemic endothelium-dependent vasoreactivity predicts recurrence of instability and cardiovascular event rates in patients with ACS. Assessment of systemic vasoreactivity measured by a minimally invasive test, provides important prognostic information in addition to that derived from traditional risk factor assessment in patients with ACS. Also, endothelium-dependent dilation of the brachial artery is a strong in dependent predictor of adverse outcome in survivors of ACS without ST-segment elevation