Clinical assessment of endothelial dysfunction: combine and rule

PURPOSE OF REVIEW: To briefly survey the literature for the past 2-3 years on the subject of diagnostic and prognostic markers of endothelial cell dysfunction. RECENT FINDINGS: Established and emerging techniques to detect endothelial cell dysfunction are divided into two large families: (1) functional and structural markers of endothelial cell dysfunction, and (2) surrogate markers of endothelial cell dysfunction. The first category includes high-resolution Doppler studies of conduit arteries, laser Doppler flowmetry of cutaneous microvasculature, and measurements of arterial stiffness and intima: media thickness. The second category of tests provides brief descriptions of detection of oxidative stress, inflammation, coagulation abnormalities, circulating endothelial cells and microparticles. I also focus on integration of various techniques and some novel genomic, proteomic and metabolomic tests. SUMMARY: This snapshot of existing and emerging technologies diagnosing endothelial cell dysfunction is intended to provide the foundation for the future (a) development of personalized noninvasive screening of endothelial function, and (b) delineation of preclinical diagnostic biomarkers heralding cardiovascular complications.