Pathophysiology of coronary vasomotor tone

The Authors focus the great importance of the endothelium-dependent relaxation in normal and diseased human coronary arteries. The impairment or loss of this powerful dilator process, that is multifactorial and related to the stage of development of the endothelial damage seems to be, beyond all doubt, implicated with vasospasm and thrombosis. Furthermore the response of coronary smooth muscles to vasoconstrictors, particularly to serotonin, may be augmented. These vasoconstrictors may be present in larger amount at the site of the rupture of atheromatous plaque, following platelet deposition and aggregation that trigger the release of platelet-derived products such as ADP, 5-HT and eicosanoids. The recognition and the increasing knowledge on the relationship between endothelial-relaxing mechanism dysfunction and coronary heart disease is certainly leading to new hope for a more rational therapeutical intervention.