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[Indicators of incipient atherosclerosis: demonstration of endothelial dysfunction with high-resolution ultrasound]
B M Balletshofer1, K Rittig, J Stock
1Medizinische Klink Universität Tübingen, Abteilung Endokrinologie, Diabetes und vaskuläre Medizin. Bernd.Balletshofer@med.uni-tuebingen.de
Insights
This study reviews a non-invasive ultrasound method for measuring endothelial function, crucial for cardiovascular health. It details factors influencing flow-mediated vasodilation, aiding clinical applications and research.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Diagnostic Imaging
Background:
- Endothelial dysfunction is central to atherosclerosis, hypertension, and heart failure.
- Accurate assessment of endothelial function is vital for understanding and managing cardiovascular diseases.
Purpose of the Study:
- To review a non-invasive ultrasound technique for quantifying endothelial function.
- To discuss factors influencing flow-mediated vasodilation (FMD) measurements.
- To explore clinical applications and prognostic impact of FMD.
Main Methods:
- Utilizes high-resolution ultrasound (7-13 MHz) to measure endothelium-dependent vasodilation of the brachial artery.
- Based on increased endothelial nitric oxide (NO) production due to shear stress.
- Non-invasive, risk-free, and suitable for repeated measurements.
Main Results:
- The ultrasound technique allows for precise quantification of endothelial function.
- Numerous factors can affect flow-mediated vascular reactivity, requiring careful methodological control.
- Clinical studies demonstrate the impact of FMD on cardiovascular disease risk and prognosis.
Conclusions:
- The non-invasive ultrasound method is a valuable tool for assessing endothelial function.
- Standardization of methodology is crucial for reliable FMD measurements.
- FMD assessment has significant clinical implications for cardiovascular disease management.
Abstract:
Endothelial function is thought to play a central role in the process of atherosclerosis, and in the pathogenesis of arterial hypertension and chronic heart failure. In the last decade a non-invasive ultrasound technique has been developed to measure endothelium-dependent vasodilation of the brachial artery which allows quantification of endothelial function. This method is based upon results in basic research, which show increased endothelial NO-production following the impact of shear forces on the endothelial surface. The resulting vasodilation can be quantified with high resolution ultrasound (7-13 MHz). The advantage of this technique is its non-invasive nature, which allows a risk-free use even in young individuals. Repeated measurements to control the success of medical intervention are also not problematic. Despite the possibility of widespread use because of its deceptively simple protocol, there are numerous factors affecting flow-mediated vascular reactivity. Details of the methods applied, variations in examination procedure, image acquisition, subjects preparation, equipment, training requirements and data interpretation are reviewed in this paper. Clinical studies of cardiovascular disease, risk factor profiles and the prognostic impact of measuring flow-mediated vasodilation are also discussed.