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Updated: Aug 21, 2026
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
[Clinical assessment of major artery vasomotor endothelial function: methodology and importance for evaluating aging
Dragan Durić1, Vladimir Jakovljević, Mirjana Stojković
1drdjuric@Eunet.yu
Insights
Aging accelerates atherosclerosis, leading to increased carotid intima-media thickness and reduced vascular response. Early detection of endothelial dysfunction is crucial for primary prevention strategies against cardiovascular disease.
Area of Science:
- Cardiovascular Medicine
- Gerontology
- Vascular Biology
Background:
- Atherosclerosis is a primary cause of mortality globally and in Serbia/Montenegro, linked to aging and endothelial dysfunction.
- Vascular changes, including increased thickness and stiffness, are associated with aging and cardiovascular diseases.
- Endothelial dysfunction precedes clinical manifestations of atherosclerosis by approximately two decades.
Purpose of the Study:
- To investigate the impact of aging on vascular function and structure.
- To highlight the importance of early detection of endothelial dysfunction for cardiovascular disease prevention.
- To evaluate diagnostic methods for assessing atherosclerosis in the context of aging.
Main Methods:
- Utilized non-invasive echosonography to measure carotid intima-media thickness, an indicator of atherosclerosis.
- Assessed brachial artery diameter, blood flow, and response to reactive hyperemia.
- Measured left ventricular mass index.
Main Results:
- Aging correlates with decreased response to reactive hyperemia, increased carotid intima-media thickness, and elevated left ventricular mass.
- Endothelial dysfunction is identified as an early event in atherosclerosis development.
- A lack of time-dependent correlation between aging and specific vascular remodeling markers was observed.
Conclusions:
- Aging significantly impacts vascular health, contributing to atherosclerosis.
- Early identification of endothelial dysfunction, potentially through markers like homocysteine, is vital for primary cardiovascular prevention.
- Non-invasive diagnostic tools are essential for early detection and management of age-related vascular changes.
Unlabelled:
AGING AS A CARDIOVASCULAR RISK FACTOR: Atherosclerosis is the major cause of mortality in the Western world (>50%) as well as in Serbia and Montenegro (>60%). Atherosclerosis/arteriosclerosis functional and structural vascular changes as a consequence of angina pectoris, myocardial infarction, transient ischemic cerebrovascular attacks, stroke, ischaemic attacks in peripheral circulation and/or thromboembolic complications. Aging, lipids (oxidized LDL), infective agents, inflammation, increased glucose level, hypertension, smoking, increased homocysteine level, oxidative stress etc. are recognized as factors which lead to endothelial dysfunction and cause atherosclerosis. Thus, in response to such attacks endothelium releases different substances like: nitric oxide, prostacyclin, endothelium-derived hyperpolarizing factor (EDHF), endothelin, bradykinin, angiotensin II, free oxygen radicals etc. which could be involved in the pathogenesis of atherosclerosis. Atherosclerosis/arteriosclerosis begins with endothelial vasomotor and anti-thrombotic dysfunction and it is of strategic importance to discover this condition earlier. In regard aging, both higher thickness and stiffness of arterial blood vessels appear following an incidence of cardiovascular diseases.
Diagnostic Methods:
Over the last decade non-invasive, echosonographic method for visualization of carotid intima-media thickness (indicator of arteriosclerosis/atherosclerosis) was introduced in clinical practice. However, it is also used to compare brachial artery diameter changes, linear velocity and bloodflow which are estimated during basal conditions, during ischemia, during reactive hyperemia (endothelium/independent phase) as well as with left ventricular mass index.
Discussion And Conclusion:
Due to aging there is a decreased response to reactive hyperemia, increased carotid intima-media thickness and increased left ventricular mass, but there is a lack of time-dependent correlation. First endothelial dysfunction occur twenty years before any manifestations appear--as typical vascular and ventricular remodeling. During this period certain markers, for example homocysteine, and diagnostic procedures are important parts of primary prevention.
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