SUMMARY. Recent studies in isolated epicardial coronary artery rings have shown that the endothelium modulates vasomotor responses to certain endogenous neurohumoral agents. It is not known whether the endothelium plays a role in large coronary vasoregulation in the intact coronary circulation. Accordingly, we examined effects of endothelial removal on vasoconstrictor responses of the proximal coronary artery in anesthetized adult mongrel dogs. The left anterior descending artery was perfused at 100 mm Hg with arterial blood from a pressurized reservoir. Coronary diameter was measured continuously with 7-MHz sonomicrometer crystals attached to the adventitia of the artery. Fifteen minutes after mechanical disruption of the endothelium with a balloon-tipped catheter, baseline diameter was unchanged from a control value of 2.60 ± 0.13 mm (mean ± SE, n = 17). Endothelial denudation resulted in a dose-dependent potentiation of the constrictor response to intracoronary 5-hydroxytryptamine (1-50 jig/min, n = 8). With the endothelium intact, a 5 /ig/min infusion of 5-hydroxytryptamine reduced diameter by 24 ± 14 /im, while a 50 /ig/min dose reduced diameter by 54 ± 25 fim. After endothelial removal, the decrease in diameter averaged 74 ± 18 ^m at 5 jjg/min and 132 ± 29 /im at 50 jig/min, indicating a 10-fold increase in the sensitivity to 5-hydroxytryptamine. The constrictor responses to angiotensin II (1 and 5 jig/min, n = 7) and phenylephrine (1-5 /ig/min, n = 7) were not altered by endothelial removal. Thus, endothelial removal selectively potentiates the constrictor responses to 5-hydroxytryptamine in the intact coronary circulation of the dog. (Cite Res 57: 46-54, 1985) RECENT studies in isolated arterial preparations including coronary arteries have demonstrated an obligatory role for endothelial cells in the response of vascular smooth muscle to various neurohumoral agents. Removal of the endothelium abolishes vasodilator responses to acetylcholine, bradykinin, thrombin, and substance P (Furchgott and Zawadzki, 1980;Furchgott, 1983) and potentiates vasoconstrictor responses to 5-hydroxytryptamine (Cohen et al., 1983a;Cocks and Angus, 1983).Recently, Cohen and co-workers (1983b) demonstrated that aggregating autologous platelets cause contraction of isolated coronary artery segments. The contractions were augmented after removal of the endothelium, and were attenuated by the 5-hydroxytryptamine antagonists, ketanserin and cyproheptadine. These investigators have also demonstrated that when coronary artery segments are precontracted with prostaglandin F 2a , 5-hydroxytryptamine results in relaxation in some rings with endothelium, but results in contraction in all rings with the endothelium removed. These data suggest that the response of isolated large coronary arteries to 5-hydroxytryptamine is the net result of a direct constrictor effect on the smooth muscle which is opposed by a dilator response mediated by the endothelium (Cohen et al., 1983a). These in vitro observations have suggested that the absence o...