This review discusses current concepts for assessing endothelial function, prognostic implications of endothelial dysfunction, and underlying mechanisms focusing on oxidative stress and biomarkers.
This review summarizes the pathophysiology, diagnostic methods, and prognostic implications of endothelial dysfunction, highlighting the role of oxidative stress and circulating biomarkers.
Endothelial dysfunction (ED) in the setting of cardiovascular risk factors such as hypercholesterolemia, hypertension, diabetes mellitus, chronic smoking as well as in patients with heart failure has been shown to be at least in part dependent on the production of reactive oxygen species (ROS) such as superoxide and the subsequent decrease in vascular bioavailability of nitric oxide (NO). Methods to quantify endothelial dysfunction include forearm plethysmography, flow-dependent dilation of the brachial artery, finger-pulse plethysmography, pulse curve analysis, and quantitative coronary angiography after intracoronary administration of the endothelium-dependent vasodilator acetylcholine. Superoxide sources include the NADPH oxidase, xanthine oxidase, and mitochondria. Superoxide produced by the NADPH oxidase may react with NO released by the endothelial nitric oxide synthase (eNOS) thereby generating peroxynitrite (ONOO-), leading to eNOS uncoupling and therefore eNOS-mediated superoxide production. The present review will discuss current concepts of how to assess endothelial function, prognostic implications of ED, mechanisms underlying ED with focus on oxidative stress and circulating biomarkers, which have been proposed to indicate endothelial dysfunction and/or damage, respectively.
Münzel et al. (Tue,) conducted a review in Endothelial dysfunction. This review discusses current concepts for assessing endothelial function, prognostic implications of endothelial dysfunction, and underlying mechanisms focusing on oxidative stress and biomarkers.