Endothelitis in the pathogenesis of chronic CHD: clinical manifestations and treatment approaches

Cardiologist, General practitioner, Neurologist
Endothelitis in the pathogenesis of chronic CHD: clinical manifestations and treatment approaches

Abstract. Despite the fact that strategies to optimize the prevention and treatment of coronary heart disease (CHD) have been actively implemented in clinical practice in recent years, the consequences of this condition still represent a significant burden on human health, holding leading positions in the structure of mortality and morbidity.

The etiology of myocardial ischemia is currently being studied comprehensively. Clinical, angiographic and autopsy data indicate a complex pathophysiology of CHD that goes beyond the generally accepted and simplified role of atherosclerosis. In particular, there is a hypothesis that inflammation, affecting endothelial cells (EC), stimulates the development and evolution of atherosclerosis, and also causes the occurrence of acute thrombotic complications. At the same time, inflammation can be not only a cause, but also a consequence of CHD. In this case, it first covers the myocardium and only then becomes systemic. The endothelium plays an undeniably important role in the regulation of inflammatory reactions.

The long-term impact of triggering pathophysiological stimuli on endothelial cells is the trigger for its proinflammatory activation with the development of endotheliitis, and in the future, endothelial dysfunction, which causes chronic dysregulation of the microcirculation of organs and tissues with the subsequent development of ischemic complications.

The article reveals the role of endotheliitis and endothelial dysfunction in the pathogenesis of CHD, demonstrates their clinical consequences, and also indicates the possibilities of enhancing pathogenetic treatment.

Keywords: coronary heart disease, angina pectoris, endotheliitis, endothelial dysfunction, L-arginine, L-carnitine.

Authors: Tashchuk V.K., MD, Professor, Head of the Department of Internal Medicine, Physical Rehabilitation and Sports Medicine, Bukovynian State Medical University, Chernivtsi, Ukraine.

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