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Methods for evaluating endothelial function

a position statement from the ESC Working Group on Peripheral Circulation

Peripheral Arterial Diseases
First published online: March 11, 2011

Access free online article

Reference:
European Journal of Cardiovascular Prevention & Rehabilitation
0(00) 1–15! The European Society of Cardiology 2011
DOI: 10.1177/1741826711398179

Authors:
J Lekakis, P Abraham, A Balbarini, A Blann, C M Boulanger, J Cockcroft, F Cosentino, J Deanfield, A Gallino, I Ikonomidis, D Kremastinos, U Landmesser, A Protogerou, C Stefanadis, D Tousoulis, G Vassalli, H Vink, N Werner, I Wilkinson and C Vlachopoulos (corresponsing author)



Abstract:
The endothelium holds a pivotal role in cardiovascular health and disease. Assessment of its function was until recently limited to experimental designs due to its location. The advent of novel techniques has facilitated testing on a more detailed basis, with focus on distinct pathways. This review presents available in-vivo and ex-vivo methods for evaluating
endothelial function with special focus on more recent ones. The diagnostic modalities covered include assessment of epicardial and microvascular coronary endothelial function, local vasodilation by venous occlusion plethysmography and flow-mediated dilatation, arterial pulse wave analysis and pulse amplitude tonometry, microvascular blood flow by laser
Doppler flowmetry, biochemical markers and bioassays, measurement of endothelial-derived microparticles and progenitor cells, and glycocalyx measurements. Insights and practical information on the theoretical basis, methodological aspects, and clinical application in various disease states are discussed. The ability of these methods to detect endothelial dysfunction before overt cardiovascular disease manifests make them attractive clinical tools for prevention and rehabilitation.