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Endothelial Function-what is it?
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Endothelial dysfunction - Wikipedia, the free encyclopedia
en.wikipedia.org/wiki/Endothelial_dysfunction
In human vascular diseases, endothelial dysfunction is a systemic pathological state of the endothelium (the inner lining of blood vessels) and can be broadly
Endothelial dysfunction is thought to be a key event in the development of atherosclerosis and predates clinically obvious vascular pathology by many years[2] . This is because endothelial dysfunction is associated with reduced anticoagulant properties as well as increased adhesion molecule expression, chemokine and other cytokine release, and reactive oxygen species production from the endothelium, this leads to inflammation and myofibroblast migration and proliferation inside the vessel all of which play important roles in the development of atherosclerosis.
In fact, endothelial dysfunction has been shown to be of prognostic significance in predicting independently vascular events including stroke and myocardial infarction. Because of this, endothelial function testing may have great potential prognostic value for the early detection of cardiovascular disease; clinical trials in the recent years have demonstrated the feasibility of translating this measurement to the clinical practice
Endothelial function can be improved significantly by exercise smoke cessation , weight loss in overweighted or obese persons, and improved diet. Treatment of hypertension and hypercholesterolemia are also critical; the major pharmacological interventions to improve endothelial function in those set of patients are statins(HMGCoA-reductase inhibitor), and renin angiotensin system inhibitors, (such as ACE inhibitors and angiotensin II receptor antagonists) [28][29]. Some studies have found antioxidants, potassium[30] and arginine supplementation to restore impaired endothelial function. A positive relationship exists between the consumption of trans fat (commonly found in hydrogenated products such as margarine) and the development of endothelial dysfunction.[31] New third-generation ß-blockers and 5-phosphodiesterase inhibitors may affect endothelial function. New non-invasive strategies that measure endothelial function will prove critical to assess which set of patients are improving their endothelial function. It is interesting to note that statins have major pleiotropic anti-inflammatory and anti-hypertensive effects besides the cholesterol reduction effect. [32]This immunomodulatory effects of statins may explain why some patients improve their endothelial function with those drugs.
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