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Int J Angiol 2011; 20(3): 121-134
DOI: 10.1055/s-0031-1283220
REVIEW ARTICLE

© Thieme Medical Publishers

Nitric Oxide-Mediated Coronary Flow Regulation in Patients with Coronary Artery Disease: Recent Advances

Noboru Toda1 , Shinichi Tanabe2 , Sadanobu Nakanishi3
  • 1Toyama Institute for Cardiovascular Pharmacology Research, Osaka, Japan
  • 2Cardiology Section, Department of Internal Medicine, Social Insurance Kyoto Hospital, Japan
  • 3Department of Internal Medicine, Kyoto Prefectural University of Medicine at Kyoto, Japan
Further Information

Publication History

Publication Date:
04 July 2011 (online)

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ABSTRACT

Nitric oxide (NO) formed via endothelial NO synthase (eNOS) plays crucial roles in the regulation of coronary blood flow through vasodilatation and decreased vascular resistance, and in inhibition of platelet aggregation and adhesion, leading to the prevention of coronary circulatory failure, thrombosis, and atherosclerosis. Endothelial function is impaired by several pathogenic factors including smoking, chronic alcohol intake, hypercholesterolemia, obesity, hyperglycemia, and hypertension. The mechanisms underlying endothelial dysfunction include reduced NO synthase (NOS) expression and activity, decreased NO bioavailability, and increased production of oxygen radicals and endogenous NOS inhibitors. Atrial fibrillation appears to be a risk factor for endothelial dysfunction. Endothelial dysfunction is an important predictor of coronary artery disease (CAD) in humans. Penile erectile dysfunction, associated with impaired bioavailability of NO produced by eNOS and neuronal NOS, is also considered to be highly predictive of ischemic heart disease. There is evidence suggesting an important role of nitrergic innervation in coronary blood flow regulation. Prophylactic and therapeutic measures to eliminate pathogenic factors inducing endothelial and nitrergic nerve dysfunction would be quite important in preventing the genesis and development of CAD.

KEYWORDS

Nitric oxide - constitutive nitric oxide synthase - endothelial dysfunction - coronary blood flow - coronary artery disease - asymmetric dimethylarginine

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Noboru Toda

Toyama Institute for Cardiovascular Pharmacology Research, 7-13, 1-Chome

Azuchi-machi, Chuo-ku, Osaka 541-0052, Japan

Email: n.toda.toyama-bldg@orion.ocn.ne.jp