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Updated: Jul 16, 2026
Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
Published on: April 27, 2016
Ultrasound assessment of endothelial function in children
Mikko J Järvisalo1, Olli T Raitakari
1Department of Internal Medicine, Satakunta Central Hospital, Pori, Finland. mikko.jarvisalo@utu.fi
Insights
Ultrasound can assess early signs of atherosclerosis in children by measuring endothelial function. This noninvasive method helps identify children at high risk for future cardiovascular disease.
Area of Science:
- Cardiovascular research
- Pediatric cardiology
- Vascular biology
Background:
- Atherosclerosis is a lifelong process beginning in childhood, with endothelial dysfunction as an early pathogenic stage.
- Clinical complications typically manifest in older age but originate from early vascular changes.
- Noninvasive imaging, particularly ultrasound, allows for assessment of endothelial health in children.
Purpose of the Study:
- To evaluate the utility of noninvasive ultrasound in assessing endothelial function in children.
- To gain insights into early atherosclerosis and the impact of cardiovascular risk factors during childhood.
- To explore the potential of ultrasound-assessed endothelial function for risk stratification in pediatric populations.
Main Methods:
- Utilizing noninvasive ultrasound imaging to measure endothelial function in children.
- Assessing asymptomatic children, including those with and without cardiovascular risk factors.
- Comparing findings with established knowledge of endothelial function in adults.
Main Results:
- Ultrasound enables the assessment of endothelial health in children, providing insights into early atherosclerotic processes.
- Cardiovascular risk factors in childhood have demonstrable effects on the vasculature.
- The ultrasound test for endothelial function is affordable, safe, and accessible.
Conclusions:
- Noninvasive ultrasound assessment of endothelial function is a promising tool for identifying children at high risk for adult atherosclerosis.
- Further research is needed to address reproducibility and establish normal values for clinical application in children.
- In adults, impaired endothelial function is a known predictor of future cardiovascular events.
Abstract:
Although the clinical complications of atherosclerosis arise from developed lesions in old age, the atherosclerotic disease is a lifelong process with roots in childhood. Endothelial dysfunction is currently considered an early stage in the pathogenesis of atherosclerosis, which precedes the formation of structural atherosclerotic changes. Improvements in noninvasive imaging modalities, mainly in ultrasound imaging, have made it possible to assess the endothelial health of asymptomatic children with or without cardiovascular risk factors. By using noninvasive ultrasound for endothelial function, important insights have been gained into the early stages of atherosclerosis and the effects of cardiovascular risk factors on vasculature in childhood. The ultrasound test of endothelial function is affordable, available, and safe and may be considered a potent aid in clinical risk stratification of children at high risk for subsequent clinical atherosclerosis in adulthood. At present, this methodology serves only research purposes, as many issues including reproducibility and normal values for healthy children need to be solved before clinical use can be considered. In adults, however, recent studies have shown that attenuated endothelial function predicts the occurrence of future cardiovascular events.
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