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Evaluating endothelial function in humans: a guide to invasive and non-invasive techniques

2005; BMJ; Volume: 91; Issue: 4 Linguagem: Inglês

10.1136/hrt.2003.032847

1468-201X

Dimitris Tousoulis,

Blood Pressure and Hypertension Studies

he endothelium regulates vascular homeostasis through the release of a variety of autocrine and paracrine substances, such as nitric oxide (NO), prostacyclin, and the endothelium derived hyperpolarising factor(s). 1Beyond its vasodilatory effects, NO has antiatherogenic properties, inhibits platelet aggregation and adhesion, smooth muscle cell proliferation, leucocyte adhesion, vascular permeability, and inflammatory mechanisms (fig 1). 1 Several prospective and retrospective studies have shown that evaluation of endothelial function may be useful in identifying subjects at high risk for atherosclerosis, as well as for risk stratification of patients with already established coronary artery disease. 2 w1 Several invasive and non-invasive techniques have been developed during the last few years to evaluate endothelial function.Invasive techniques, which involve intracoronary or intrabrachial infusions of vasoacting agents, are still considered to be the gold standard for early detection of endothelial dysfunction.In addition, several non-invasive techniques have been developed, with comparable results and good reproducibility.In this article we describe and evaluate the different methods for assessing endothelial function in humans.