Fundamentals of endothelial function for the clinical cardiologist
Fundamentals of endothelial function for the clinical cardiologist
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DOI：
10.1161/hc0502.104540
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发表时间：
2002-02-05
期刊：
影响因子：
37.8
通讯作者：
Anderson, TJ
中科院分区：
文献类型：
--
作者：
Verma, S;Anderson, TJ
病例介绍1：Gundry先生是一名42岁的建筑工人，过去6年患有II型糖尿病。他没有其他血管危险因素，目前无症状。该患者是否有发生内皮功能障碍的风险？病例介绍2：Sinha先生是一位64岁的男性，因间歇性跛行症状到您的办公室就诊。除存在多种血管风险因素（吸烟、高血压、血脂异常和肥胖）外，既往病史无异常。血管危险因素如何导致内皮功能障碍？内皮功能障碍可以治疗吗？对医学史的调查将揭示，重大突破往往是简单的，有时是意想不到的观察的结果。事实上，内皮生物学的时代是通过大约20年前在Furchgott博士的实验室进行的一个简单的药理学实验而被带到前沿的。1在这项具有里程碑意义的研究中，作者描述了内皮在介导乙酰胆碱的血管舒张作用中的重要作用，现在已知乙酰胆碱依赖于内皮释放一氧化氮（NO）。没有人能预测到这一观察结果会对今天的血管生物学产生巨大的影响。血管内皮功能障碍与大多数心血管疾病的发病机制和临床过程有关。本“临床心脏病学：医师更新”的目的是为忙碌的心血管专家提供一些与心血管健康和疾病相关的内皮功能的基本原则。
Case presentation 1: Mr Gundry is a 42-year-old construction worker who has had type II diabetes mellitus for the past 6 years. He has no other vascular risk factors and is currently asymptomatic. Is this patient at risk of developing endothelial dysfunction? Case presentation 2: Mr Sinha is a 64-year-old man who presents to your office for symptomatic intermittent claudication. Past medical history is unremarkable except for the presence of multiple vascular risk factors (smoking, hypertension, dyslipidemia, and obesity). How do vascular risk factors cause endothelial dysfunction? Is endothelial dysfunction treatable?A survey of medical history will reveal that major breakthroughs are often a result of simple and at times unexpected observations. Indeed, the era of endothelial biology was brought to the forefront through a simple pharmacological experiment conducted approximately 2 decades ago in Dr Furchgott’s laboratory. 1 In this landmark study, the authors described the essential role of the endothelium in mediating the vasodilatory actions of acetylcholine, now known to be dependent on the release of nitric oxide (NO) from the endothelium. No one could have predicted that this observation would have the gargantuan impact on vascular biology that is evident today. Endothelial dysfunction now is implicated in the pathogenesis and clinical course of the majority of cardiovascular diseases. The purpose of this “Clinical Cardiology: Physician Update” is to provide the busy cardiovascular specialist with some of the fundamental principles of endothelial function as they relate to cardiovascular health and disease.