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Role of endothelial dysfunction in determining angina after percutaneous intervention: Learning from pathophysiology to optimize treatment.

Prog Cardiovasc Dis. 2020 Feb 12.
Role of endothelial dysfunction in determining angina after percutaneous intervention: Learning from pathophysiology to optimize treatment.
Mangiacapra F1, Del Buono MG2, Abbate A3, Gori T4, Barbato E5, Montone RA2, Crea F2, Niccoli G2.
1 Unit of Cardiovascular Science, Campus Bio-Medico University, Rome, Italy. Electronic address: f.mangiacapra@unicampus.it.
2 Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy.
3 VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States of America.
4 Kardiologie I, Zentrum für Kardiologie, University Medical Center Mainz and DZHK Standort Rhein-Main, Mainz, Germany.
5 Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy.
Abstract
Endothelial dysfunction (EnD) is a hallmark feature of coronary artery disease (CAD), representing the key early step of atherosclerotic plaque development and progression. Percutaneous coronary intervention (PCI) is performed daily worldwide to treat symptomatic CAD, however a consistent proportion of patients remain symptomatic for angina despite otherwise successful revascularization. EnD plays a central role in the mechanisms of post-PCI angina, as it is strictly associated with both structural and functional abnormalities in the coronary arteries that may persist, or even accentuate, following PCI. The assessment of endothelial function in patients undergoing PCI might help to identify those patients at higher risk of future cardiovascular events and recurrent/persistent angina who might therefore benefit more from an intensive treatment. In this review, we address the role of ED in determining angina after PCI, discussing its pathophysiological mechanisms, diagnostic approaches and therapeutic perspectives.
Copyright © 2020. Published by Elsevier Inc.
KEYWORDS:
Angina; Endothelial dysfunction; Microvascular dysfunction; Percutaneous coronary intervention; Recurrent angina
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