Endothelial dysfunction in the pathogenesis of vascular accidents in cardiovascular diseases

Abstract

Modern data about mechanism of endothelium contribution to onset and development of vascular failures in cardio-vascular diseases are represented in the article. Development of vascular failures – myocardial infarction, stroke, unstable angina, which lead to sudden death, can be as a result of acute vascular spasm, thrombus’ forming and rupture of atherosclerotic plaque. Aim – to analyze scientific literature to summarize data about contemporary views on the role of endothelial dysfunction in the mechanisms of vascular events. Key pathogenesis mechanisms, including the role of endothelium’s dysfunction, are arguable. Vascular wall defect is an important initial part of cardio-vascular pathology development – from risk factors to the death. Mechanism are multifaceted and associated with vascular tonus regulation, intactness of vascular wall, atherogenesis processes and hemostasis system. Endothelial dysfunction, determined by any pathogenic factor, leads to increased lipoproteins’ permeability and disturbance of lipid-transport system in general. Functional lipid-transport system disorders are associated with blood plasma’s lipolytic activity. New data about contribution of heparin deficiency in progressive endothelial dysfunction’s pathogenesis along with active correction of blood reologic properties in aterogenesis are represented. Conclusions. Endothelial dysfunction in modern understanding is not only pathology of vascular wall, but a deep and complex system of disturbances and compensatory-adaptive reactions, which originates on molecular-genetic level. Study of the initial mechanisms of endothelial function dysregulation in vascular failures can be the prospective direction of modern medicine. Further researches of the primary injuring factor’s nature, which causes the vascular failures, can give not only the possibility to effect on pathogenetic mechanisms of cardio-vascular diseases development, but foresee and prevent the sudden death, increase the life expectancy.

Keywords

• endothelium vascular
• cardiovascular deconditioning
• heparin
• lipid metabolism