Experience with measuring endothelium-dependent vasodilation usingduplex sonography

Overview

Impaired endothelium dependent vasodilation in present already in the initial stage of atheroscleroticprocess. Furthermore, endothelial dysfuncttion is a typical marker of the unstable(fragile) atherosclerotic plaque. According to some authors, measurement ot the endothelialresponse to vasodilatory stimuli may contribute to a better risk assessment of acute cardiovascularcomplications in primary as well as secondary prevention.In our department, we introduced the endothelium dependent vasodilation measurementcarried out by Celermajer et al. This article presents our experience with this method afterhaving examined 252 subjects. The lab equipment as well as the examination protocol isdescribed below. The examination and the sonographic evaluation of the vasodilation measurementmust be performed under strictly standard conditions. The limitation factors for thephysician and for the patients are mentioned in detail. To our opinion, this method is notassessed for routine clinical use to evaluate the acute cardiovascular risk in one certain patient,due ti the variability of endothelium dependent vasodilation and somewhat demanding examinationprocedure. However, this measurement might be aseful for study purposes.

Key words:
endothelium - vasodilatation - atherosclerosis - duplex sonography.