Microscopic Structure of Vascular Endothelial Cells with Special Reference to Coronary Artery Disease and Diabetes Mellitus

Endothelial cells are the single layer of cells lining the interior of the cardiovascular system, including the heart, arteries, capillaries, and veins. They play a crucial role in maintaining vascular health and function through a variety of processes, including regulating blood flow through secreted factors that cause blood vessels to constrict or dilate, ensuring proper blood supply to different organs. Capillaries, with their porous endothelial lining, facilitate the exchange of nutrients, oxygen, and waste products between blood and tissues. Endothelial cells produce substances that prevent blood clotting within healthy vessels and promote clotting at injury sites. They share immune response and angiogenesis. This review highlights the role of endothelial dysfunction in development of various diseases, with a particular focus on non-obstructive coronary artery disease and diabetes mellitus. Non-obstructive coronary artery disease is primarily caused due to endothelial dysfunction, characterized by impaired nitric oxide production and a decrease in vasodilatory capacity. Symptoms may include chest pain, shortness of breath, and fatigue. Early detection and treatment of endothelial dysfunction are crucial to prevent complications. On the other hand, chronic hyperglycemia in diabetes mellitus damages endothelial cells, contributing to various complications. These complications can be categorized as microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular (coronary artery disease, stroke, and peripheral artery disease). Hyperglycemia triggers multiple pathways that damage endothelial cells, including the formation of advanced glycation end-products (AGEs), oxidative stress, and inflammation. The review concludes that endothelial cell biomarkers can offer the potential for monitoring endothelial health and disease progression. Further research on endothelial cell biomarkers is warranted to improve diagnosis and guide treatment strategies.