Endothelial function in cardiovascular medicine: a consensus paper of the European Society of Cardioloy working Groups on Artherosclerosis and Vascular Biology, Aorta and Perirpheral Vascular Diseases, Coronary Pathophysiology and Microcirculation, and Thrombosis
Por:
Alexander, Y, Osto, E, Schmidt-Trucksass, A, Shechter, M, Trifunovic, D, Duncker, DJ, Aboyans, V, Back, M, Badimon, L, Cosentino, F, De Carlo, M, Dorobantu, M, Harrison, DG, Guzik, TJ, Hoefer, I, Morris, PD, Norata, GD, Suades, R, Taddei, S, Vilahur, G, Waltenberger, J, Weber, C, Wilkinson, F, Bochaton-Piallat, ML, Evans, PC
Publicada:
1 ene 2021
Resumen:
Endothelial cells (ECs) are sentinels of cardiovascular health. Their function is reduced by the presence of cardiovascular risk factors, and is regained once pathological stimuli are removed. In this European Society for Cardiology Position Paper, we describe endothelial dysfunction as a spectrum of phenotypic states and advocate further studies to determine the role of EC subtypes in cardiovascular disease. We conclude that there is no single ideal method for measurement of endothelial function. Techniques to measure coronary epicardial and micro-vascular are well established but they are invasive, time-consuming, and expensive. Flow-mediated dilatation (FMD) of the brachial arteries provides a non-invasive alternative but is technically challenging and requires extensive training and standardization. We, therefore, propose that a consensus methodology for FMD is universally adopted to minimize technical variation between studies, and that reference FMD values are established for different populations of healthy individuals and patient groups. Newer techniques to measure endothelial function that are relatively easy to perform, such as finger plethysmography and the retinal flicker test, have the potential for increased clinical use provided a consensus is achieved on the measurement protocol used. We recommend further clinical studies to establish reference values for these techniques and to assess their ability to improve cardiovascular risk stratification. We advocate future studies to determine whether integration of endothelial function measurements with patient-specific epigenetic data and other biomarkers can enhance the stratification of patients for differential diagnosis, disease progression, and responses to therapy.
Filiaciones:
Alexander, Y:
Manchester Metropolitan Univ, Fac Sci & Engn, Ctr Biosci, Manchester, Lancs, England
Osto, E:
Univ Zurich, Inst Clin Chem, Zurich, Switzerland
Univ Hosp Zurich, Univ Heart Ctr, Zurich, Switzerland
Swiss Fed Inst Technol, Lab Translat Nutr Biol, Zurich, Switzerland
Schmidt-Trucksass, A:
Univ Basel, Med Fac, Dept Sport Exercise & Hlth, Div Sports & Exercise Med, Basel, Switzerland
Shechter, M:
Chaim Sheba Med Ctr, Leviev Heart Ctr, Tel Hashomer, Israel
Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel
Trifunovic, D:
Univ Belgrade, Fac Med, Clin Ctr Serbia, Cardiol Dept, Belgrade, Serbia
Duncker, DJ:
Univ Med Ctr Rotterdam, Thoraxctr, Dept Cardiol, Div Expt Cardiol,Erasmus MC, Rotterdam, Netherlands
Aboyans, V:
Limoges Univ, Dupuytren Univ Hosp, Dept Cardiol, Inserm U 1094, Limoges, France
Back, M:
Karolinska Univ Hosp, Ctr Mol Med, Dept Cardiol, Stockholm, Sweden
Univ Lorraine, Ctr Hosp Reg Univ Nancy, INSERM U1116, Vandoeuvre Les Nancy, France
Badimon, L:
Autonomous Univ Barcelona, CiberCV, Cardiovasc Program ICCC, IR Hosp Santa Creu & St Pau, Barcelona, Spain
Cosentino, F:
Karolinska Inst, Unit Cardiol, Stockholm, Sweden
Karolinska Univ Hosp, Stockholm, Sweden
De Carlo, M:
Azienda Osped Univ Pisana, Catheterizat Lab, Pisa, Italy
Dorobantu, M:
CarolDavila Univ Med & Pharm, Bucharest, Romania
Harrison, DG:
Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA
Guzik, TJ:
Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland
Jagiellonian Univ, Dept Med, Coll Med, Krakow, Poland
Hoefer, I:
Univ Med Ctr Utrecht, Lab Clin Chem & Hematol, Utrecht, Netherlands
Morris, PD:
Univ Sheffield, Bateson Ctr, Dept Infect Immun & Cardiovasc Dis, Sheffield S10 2RX, S Yorkshire, England
Univ Sheffield, Insigneo Inst, Sheffield S10 2RX, S Yorkshire, England
Insigneo Inst In Silico Med, Sheffield, S Yorkshire, England
Norata, GD:
Univ Milan, Dept Pharmacol & Biomol Sci, Milan, Italy
Suades, R:
Karolinska Inst, Unit Cardiol, Stockholm, Sweden
Karolinska Univ Hosp, Stockholm, Sweden
Taddei, S:
Univ Pisa, Dept Clin & Expt Med, Pisa, Italy
Vilahur, G:
Autonomous Univ Barcelona, CiberCV, Cardiovasc Program ICCC, IR Hosp Santa Creu & St Pau, Barcelona, Spain
Waltenberger, J:
Univ Munster, Med Fac, Dept Cardiovasc Med, Munster, Germany
SRH Cent Hosp Suhl, Suhl, Germany
Weber, C:
Ludwig Maximillian Univ LMU Munchen, Inst Cardiovasc Prevent IPEK, Munich, Germany
German Ctr Cardiovasc Res DZHK, Partner Site Munich Heart Alliance, Munich, Germany
Munich Cluster Syst Neurol SyNergy, Munich, Germany
Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Dept Biochem, Maastricht, Netherlands
Wilkinson, F:
Manchester Metropolitan Univ, Fac Sci & Engn, Ctr Biosci, Manchester, Lancs, England
Bochaton-Piallat, ML:
Univ Geneva, Fac Med, Dept Pathol & Immunol, Geneva, Switzerland
Evans, PC:
Univ Sheffield, Bateson Ctr, Dept Infect Immun & Cardiovasc Dis, Sheffield S10 2RX, S Yorkshire, England
Univ Sheffield, Insigneo Inst, Sheffield S10 2RX, S Yorkshire, England
Insigneo Inst In Silico Med, Sheffield, S Yorkshire, England
Green Accepted, Green Published
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