Comprehensive assessment of vascular health in patients; towards endothelium-guided therapy

Pharmacol Rep. 2015 Aug;67(4):786-92. doi: 10.1016/j.pharep.2015.05.010. Epub 2015 Jun 3.


Endothelial function has diagnostic, prognostic and therapeutic significance. A number of non-invasive techniques were introduced for its assessment, including flow-mediated dilation (FMD), finger plethysmography (RH-PAT) and digital thermal monitoring (DTM). All these methods can be performed simultaneously. In addition, various methods for measuring arterial wall stiffness are available such as: pulse wave analysis (PWA), pulse wave velocity (PWV), pulse contour analysis (PCA) and carotid wall distensibility coefficient (DC). Finally, carotid intima-media thickness (cIMT) and ankle brachial index (ABI) are used as surrogate read-outs of atherosclerosis. Here, we briefly describe the advantages, limitations and interrelationships of various methods used for the assessment of endothelial function, arterial stiffness, and present the concept of an integrated evaluation of vascular health based on multiple methods. This strategy may be useful to stratify cardiovascular risk and represents a step towards multiparametric assessment of endothelium for effective endothelium-guided therapy in patients with cardiovascular diseases.

Keywords: Artery stiffness; Endothelial dysfunction; Flow-mediated dilation; Multiparametric assessment; Peripheral artery tonometry.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Flow Velocity / physiology*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / physiopathology
  • Carotid Intima-Media Thickness / trends
  • Endothelium, Vascular / pathology
  • Endothelium, Vascular / physiology*
  • Health Status*
  • Humans
  • Pulse Wave Analysis / methods*
  • Pulse Wave Analysis / trends
  • Risk Factors
  • Vascular Stiffness / physiology*