Far from being inert, it is metabolically active and produces a variety of vasoactive mediators. The vascular endothelium is a monolayer of cells between the vessel lumen and the vascular smooth muscle cells. It plays a number of roles that are important for the functioning of the cardiovascular system. The heart wall is divided into three layers: epicardium, myocardium, and endocardium. The endothelium is a layer of cells on the inside of blood vessels and the heart. The tone of the endothelial layer also determines how much work is needed from the heart to pump blood through the body. The endothelium is a thin membrane that coats the inside of blood vessels and the heart. However, research over the last 25 years has shown that the endothelium is an active, multi-functional organ that plays a vital role in metabolic, immunologic, and cardiovascular health. Damage to the cardiovascular endothelium not only develops with heart disease, but is one of the first steps on the path to heart disease, detectable even before structural changes to the vessel wall are apparent. Damaged endothelium therefore contributes to hypertension. The endothelium weighs approximately 1 kg in the average patient and covers a total surface area of 4000 to 7000 square meters. Superiorly, is the second layer: a subendocardial connective tissue which is continuous with the connective tissue of the myocardium. The endothelial layer has a tone that contributes to the control of blood pressure. As mentioned earlier the endothelial cells do a lot more than just regulate blood flow with nitric oxide, so damaging them has many other consequences. The heart wall is composed of connective tissue, endothelium, and cardiac muscle. The endothelium, which forms the inner cell lining of all blood vessels and lymphatics in the body, is a spatially distributed organ. The endothelial cells ultimately determine the health of your blood vessels and play a ⦠Also, it lines the heart cavities. Branches of the heartâs conduction system are immersed into the subendocardial layer. The endothelium is vital to the proper functioning in the heart, in particular due to its production of nitric oxide (NO) which regulates vascular tone. Endothelia are considered the âbrainsâ of blood vessels. It is the cardiac muscle that enables the heart to contract and allows for the synchronization of the heartbeat. Because it is adjacent to the bloodstream, the endothelium can signal a blood vesselâs muscle to respond to changes in pressure and inflammation. Furthermore, this tissue has an embryonic mesodermal origin. Damage to the endothelium contributes to the development of atherosclerosis, and hence to possible myocardial infarction and subsequent heart failu ⦠The layer assists in the regulation of mechanisms involved in blood clotting. 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