Role of Circulating Endothelin-1 and Tissue Immunoreactivity in Coronary Artery Disease

Endothelial cell dysfunction is the early and key factor in the development of atherosclerosis. Atherosclerosis may be initiated by endothelial injury, which then leads to the proliferation of intimal smooth-muscle cells. Endothelin is present in plasma, perhaps as a result of spillover from the interface of endothelial and vascular smooth muscle1. Plasma endothelin concentrations are high in conditions associated with endothelial-cell injury In healthy individuals, the predominant effect of stimulation of the endothelium is vasodilation. But in the presence of risk factors such as hypertension, diabetes mellitus, dyslipidemias and smoking, an imbalance between endothelium-derived constricting and relaxing factors results in endothelial dysfunction. It may be the cause or consequence of vascular disease and is a hallmark of known cardiovascular risk factors.