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Endothelial function in cardiovascular medicine: a consensus paper of the European Society of Cardiology Working Groups on Atherosclerosis and Vascular Biology, Aorta and Peripheral Vascular Diseases, Coronary Pathophysiology and Microcirculation, and Thrombosis

Yvonne Alexander 1 Elena Osto 2 Arno Schmidt-Trucksäss 3 Michael Shechter 4 Danijela Trifunovic 5 Dirk Duncker 6 Victor Aboyans 7, 8 Magnus Bäck 9 Lina Badimon 10 Francesco Cosentino 11 Marco de Carlo 12 Maria Dorobantu 13 David Harrison 14 Tomasz Guzik 15 Imo Hoefer 16 Paul Morris 17 Giuseppe Norata 18 Rosa Suades 19 Stefano Taddei 20 Gemma Vilahur 21 Johannes Waltenberger 22 Christian Weber 22 Fiona Wilkinson 1 Marie-Luce Bochaton-Piallat 23 Paul Evans 18, *
Abstract : Abstract 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 function 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.
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Soumis le : mardi 23 novembre 2021 - 15:50:57
Dernière modification le : lundi 6 décembre 2021 - 15:17:05

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Yvonne Alexander, Elena Osto, Arno Schmidt-Trucksäss, Michael Shechter, Danijela Trifunovic, et al.. Endothelial function in cardiovascular medicine: a consensus paper of the European Society of Cardiology Working Groups on Atherosclerosis and Vascular Biology, Aorta and Peripheral Vascular Diseases, Coronary Pathophysiology and Microcirculation, and Thrombosis. Cardiovascular Research, Oxford University Press (OUP), 2021, 117 (1), pp.29-42. ⟨10.1093/cvr/cvaa085⟩. ⟨hal-03443781⟩

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