Non-invasive assessment of endothelial function: which technique?

Area of Science:

• Cardiovascular Research
• Vascular Biology
• Diagnostic Techniques

Background:

• Endothelial dysfunction is an early indicator of pre-clinical atherosclerosis.
• Flow-mediated dilation (FMD) is the gold standard for assessing endothelial function but is costly and technically challenging.
• Pulse wave analysis (PWA) and pulse contour analysis (PCA) using salbutamol are potential non-invasive alternatives.

Purpose of the Study:

• To compare the reproducibility of FMD, PWA, and PCA in assessing endothelial function in adults and children.
• To evaluate the utility of these techniques in detecting vascular dysfunction during acute inflammation.

Main Methods:

• Concurrent testing of FMD, PWA, and PCA in 16 adults and 16 children.
• Assessment of vascular responses to inhaled salbutamol.
• Evaluation of techniques before and after induced acute inflammation (typhoid vaccination) in 18 men.

Main Results:

• FMD demonstrated high reproducibility in both adults and children (CV < 7.1%).
• Salbutamol-induced PWA showed moderate variability (CV up to 17.1%), while PCA exhibited significant variability, especially in children (CV up to 36.3%).
• FMD and PWA responses decreased after typhoid vaccination, indicating impaired endothelial function, whereas PCA remained unchanged.

Conclusions:

• FMD is the most reproducible method for assessing endothelial function and remains superior for serial measurements, particularly in children.
• PWA with salbutamol is a feasible alternative for detecting vascular dysfunction during acute inflammation.
• PCA's high variability limits its current use for serial endothelial function assessment, especially in pediatric populations.