ABSTRACT
This article examines the relationship between endothelial dysfunction and ``small
vessel disease.'' Newer technologies have facilitated the study of this issue. Using
a Doppler wire and the intracoronary administration of acetylcholine and papaverine,
a difference can be made between functional and chronic-trophic disturbances of the
coronary reserve. Papaverine induces smooth muscle cell-mediated vasodilation, acetylcholine
induces nitric oxide (NO)-mediated vasodilation. The data revealed that endothelial
dysfunction may be related to disturbances in the microcirculation. In addition to
those vasomotor-related properties, other factors such as antithrombotic, antiadhesive
disturbances contribute to the disturbed microcirculation. Newer techniques, such
as serial positron emission tomography, may yield an even better understanding of
these processes.
KEYWORD
Endothelium - endothelial dysfunction - NO - small vessel disease - Doppler technology
