الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The endothelium is a dynamic, heterogeneous, disseminated organ that possesses vital secretory, synthetic, metabolic, and immunologic functions . Endothelial dysfunction can be defined as, the partial or complete loss of balance between vasoconstrictors and vasodilators, growth promoting and growth inhibiting factors, proatherogenic and anti-atherogenic factors. Epicardial and microvascular coronary endothelial dysfunction is an independent predictor of acute cardiovascular events irrespective of presence or absence of angiographically detectable coronary lesions.The study aimed to evaluate any change in endothelial function in relation to severity of atherosclerotic coronary artery disease. This prospective comparative study that comprised 198 patients for whom coronary angiograghy were performed at Mansoura University specialized medical Hospitals in the period from January, 2014 to December, 2016 and comprised 198 patients to 51 of them with normal Coronary angiogram , 83 with non-obstructive Coronary angiogram and 64 with obstructive Coronary angiogram Patients with valvular heart disease, previous CABG or coronary intervention, marked anemia, heart failure and decompensated liver, renal diseases were excluded from this study. Results: Significant increase mean age among obstructive CA group than both Normal CA group and non- obstructive CA Group. Significant increased prevalence of positive age risk, gender risk (male), Hypertension, smoking, Positive Family History of CAD, increase number of risk factors, Dyslipidemia and Previous MI among obstructive CA group than both Normal CA group and non-obstructive CA group . Significant increase prevalence of typical angina pain, dyspnea, palpitation among obstructive CA group than both Normal CA group and non-obstructive CA group Significant increase prevalence of ischemic and infarction ECG pattern among obstructive CA group than both Normal CA group and non-obstructive CA Group. Significant decrease in EF among obstructive CA group than both Normal CA group and non-obstructive CA Group. Significant increase prevalence of abnormal LV systolic performance, LVH, abnormal RSWM among obstructive CA group than both Normal CA group and non-obstructive CA Group. Conclusion: Endothelial dysfunction is related to severity of coronary artery disease. Both FMD and NID are an inexpensive and non-invasive test provides information regarding extent and severity of coronary artery disease. Combination of FMD and NID measurement could more accurately predict cardiovascular events than either FMD or NID alone.