[Methods to evaluate the vascular endothelial function]

When the vascular endothelial function fails, arterial atherosclerosis is developed. Furthermore, if the endothelial dysfunction progresses, it is known to cause angina pectoris, myocardial infarction, cerebrovascular accident. By medical therapy and replacement therapy, correction of the life style, the endothelial dysfunction is understood that it could be improved reversibly. Therefore, it is very important to evaluate the vascular endothelial function for arteriosclerotic severity and the prediction of the cardiovascular disease onset and the effect of medical therapy. In the 1990s, high-frequency ultrasonographic imaging of the brachial artery to assess endothelium-dependent flow-mediated vasodilation (FMD) was developed. This technique is attractive because it is noninvasive and allows repeated measurements. However, despite its widespread use, there are technical and interpretive limitations. Therefore, for clinical application of the endothelial function test, its problems must be understood well.