The aim of the study was to evaluate the role of endothelial dysfunction according to test with reactive hyperemia and blood serum level of endothelin-1, as well as the role of systemic immune inflammation according to blood serum level of interleukin-6 in induction of myocardial ischemia under physical exercise in patients with hemodynamically insignificant coronary atherosclerosis (HICA). The study included 70 patients with HICA,
according to coronary arteriography (CAG), who formed the main group, and 50 healthy persons with intact coronary arteries according to CAG and a negative result of exercise test (control group). Depending on the
exercise test the patients with HICA were divided into two sub-groups: with a positive and negative test for ischemia. In addition to general clinical, instrumental and laboratory studies, we studied the levels of endothelin-1, interleukin-6 and serum lipid profile; the test with reactive hyperemia was performed. It was established that in patients with hemodynamically insignificant coronary atherosclerosis positive result of the exercise test, observed in 31.4 % cases, was associated with the presence of endothelial dysfunction (reduction of EDVD and increased serum endothelin-1). Patients with hemodynamically insignificant coronary atherosclerosis, comparable to healthy persons by age, gender, BMI, smoking and serum level of cholesterol, had increase level of interleukin-6, which didn’t depend on the result of the exercise test.