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Updated: Aug 15, 2026
Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
Published on: April 27, 2016
Endothelial function and its assessment
Dirk C Felmeden1, Gregory Y H Lip
1University Department of Medicine, City Hospital, Birmingham, UK.
Insights
Endothelial dysfunction, a key factor in atherosclerosis, impacts cardiovascular health. Understanding its mechanisms and assessment methods is crucial for evaluating treatments and developing new cardiovascular drugs.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Pharmacology
Background:
- Endothelial dysfunction is a hallmark of atherosclerosis and atherothrombotic vascular disease.
- It represents target organ damage in cardiovascular conditions like hypertension.
- Understanding endothelial function is vital for assessing disease and guiding drug development.
Purpose of the Study:
- To review methods for assessing endothelial function.
- To elucidate the mechanisms of endothelial dysfunction.
- To explore the impact of treatments on endothelial function.
Main Methods:
- Overview of biochemical markers for endothelial function assessment.
- Discussion of invasive and non-invasive tools for endothelial function measurement.
- Analysis of clinical relevance of various assessment techniques.
Main Results:
- Endothelial dysfunction is an early feature in atherothrombotic disease.
- Assessment methods vary in their ability to quantify endothelial function.
- Various treatments can modulate endothelial function through different mechanisms.
Conclusions:
- Comprehensive understanding of endothelial function and dysfunction is essential.
- Accurate assessment methods are necessary for evaluating therapeutic interventions.
- Targeting endothelial pathways offers potential for novel cardiovascular drug development.
Abstract:
Endothelial dysfunction is a characteristic aspect of most of the conditions associated with atherosclerosis and is commonly found as an early feature in atherothrombotic vascular disease. An appreciation of the underlying mechanisms of endothelial function, as well as dysfunction, is essential as this has critical influence on the different methods in the assessment of endothelial function and effects of various treatments on its quantification. Furthermore, endothelial dysfunction is recognised as a type of 'target organ damage' in common cardiovascular conditions (e.g., hypertension) and the area is of increasing interest for new drug development, as therapies that modulate the endothelium will have added advantages; thus, for the development of new/experimental drugs, an awareness of ways to assess the endothelium is necessary. In this review, an overview of different methods including biochemical markers, and invasive and non-invasive tools, to determine endothelial function is presented as well as their clinical relevance. Furthermore, the effects of various treatments on endothelial dysfunction and their underlying mechanisms are elucidated.
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