Ultrasound evaluation of vascular function in patients at risk for atherosclerosis is applied in clinical practice. The significance of endothelial dysfunction and intima-medial thickening and their long-term consequences remain unknown. Endothelial dysfunction and alteration of the mechanical properties of the arterial wall are observed early in life in children harboring classic cardiovascular risk factors or conditions known to confer a risk of premature atherosclerosis in adults.
My personal opinion is brachial ultrasonography still provides the responses that can be useful either in clinical practice or in establishing the risk prevention.
Dear Prof. Anil Kumar,
1. Inflammation of the artery could be studied using non-invasive infrared thermal camera. An increased skin surface temperature could be seen at the affected region than the normal region.
2. Ankle-Brachial Index (ABI) Pressure could be used to check the perfusion capability of the lower extremities.
I agree with A. Leone. In this case, I would go for the measure of flow mediated dilation by ultrasonography of brachial artery. Then If you want to distinguish beween endothelial or vsacular smooth muscle injury, you should also evaluate vasodilation of brachial artery induced by NO donor (e.g. nitroglycerine).
I agree with Guerrero. Using NO donors like Nitroprusside or TNG would help to differentiate between endothelial or vascular smooth muscle dysfunction.
In clinical Laboratory studies , measurement of Circulating PCRhS, isoleuquine 6 MMproteinase 2 and 9, contribute to image studies like Guerrero and other our colleages answer .
I use "Global Pulse Wave Velocity" but it can be performed only by Echo. But carotid-femoral PWV can be done by tonometers.
It sounds like you are describing the original study by Celermajer et al.! if you wish to perform a similar study FMD and NTG would be good options. Recently, we have used a model of passive limb movement (PLM) to elicit hyperemia, and found that the majority of this hyperemia is due to NO. This might also be a good option. If you are specifically asking about blood assays, endothelial microparticles has been suggested as a surrogate for endothelial injury, among other classic indicators (e.g. ET-1).
For endothelial function evaluation, I prefer FMD, but it's not convenient in daily clinics. To evaluate the function of large artery, PWV, especially cfPWV should be the best.
FMD or arterial stiffness; I am not a huge fan of cfPWV, although it is easy and practical.
I'd rather use different systems (SphygmoCor) or, even better, MRI to calculate PWV.
Most convenient method is assessment of FMD by ultrasonography following brachial occlusion, which is the "gold-standard" of non-invasive endothelial function evaluation. However, more and more evidence favour the importance to normalised FMD measurement to either by shear stress, BF, baseline arterial diameter, ...
Please see the attached paper for reference on assessment of endothelial function.
Article The Assessment of Endothelial Function From Research Into Cl...
