Endothelial dysfunction (EnD) is a hallmark feature of coronary artery disease (CAD), representing the key early step of atherosclerotic plaque development and progression. Percutaneous coronary intervention (PCI) is performed daily worldwide to treat symptomatic CAD, however a consistent proportion of patients remain symptomatic for angina despite otherwise successful revascularization. EnD plays a central role in the mechanisms of post-PCI angina, as it is strictly associated with both structural and functional abnormalities in the coronary arteries that may persist, or even accentuate, following PCI. The assessment of endothelial function in patients undergoing PCI might help to identify those patients at higher risk of future cardiovascular events and recurrent/persistent angina who might therefore benefit more from an intensive treatment. In this review, we address the role of EnD in determining angina after PCI, discussing its pathophysiological mechanisms, diagnostic approaches and therapeutic perspectives.

内皮功能障碍 (EnD) 是冠状动脉疾病 (CAD) 的标志性特征，代表了动脉粥样硬化斑块发展和进展的关键早期步骤。全世界每天都进行经皮冠状动脉介入治疗 (PCI) 以治疗有症状的 CAD，然而，尽管血运重建成功，仍有一部分患者仍存在心绞痛症状。EnD 在 PCI 后心绞痛的机制中起着核心作用，因为它与冠状动脉的结构和功能异常密切相关，这些异常可能在 PCI 后持续存在，甚至加重。对接受 PCI 的患者内皮功能的评估可能有助于识别那些未来发生心血管事件和复发性/持续性心绞痛风险较高的患者，他们因此可能从强化治疗中获益更多。