Correlation between Endothelial Function and the Extent of Coronary Atherosclerosis

ABSTRACT

BACKGROUND AND OBJECTIVES: The purposes of this study were to provide evidence of any correlation between the endothelial dysfunction and the extent of coronary atherosclerosis, and the relationship between the endothelial function and individual atherosclerosis risk factors in patients with significant coronary artery stenosis. SUBJECTS AND METHODS: The endothelial function was measured by hyperemia induced brachial artery dilation, using high resolution ultrasound, in 284 consecutive patients (mean age 59 years, men 176) having undergone coronary angiography. The subjects were divided into four groups according to the number of coronary arteries narrowed by more than 50%; 0 (n=88), 1 (n=98), 2 (n=54) and 3 (n=44). The endothelial functions were compared to see if significant coronary artery disease was present, according to the groups and the presence of individual atherosclerosis risk factors. RESULTS: There were no significant differences in the endothelial dysfunction between the narrowed and normal coronary artery groups (4.66+/-2.45% vs. 4.43+/-1.53% p>0.05) or between the four groups. The endothelial function in patients with significant coronary artery stenosis (n=196) was significantly lower when coupled with hypertension (n=84, 2.99+/-2.4% vs. 4.20+/-2.4%, p<0.05), diabetes (n=44, 4.07+/-2.7% vs. 4.84+/-2.5%, p<0.05) and hypercholesterolemia (n=82, 4.26+/-1.9% vs. 4.95+/-2.7%, p<0.05), but not with smoking. CONCLUSION: The endothelial function showed no difference according to the extent of coronary atherosclerosis. Risk factors of atherosclerosis, such as hypertension, diabetes mellitus and hypercholesterolemia, can deteriorate the endothelial function further, even in the patients with significant coronary artery stenosis.