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Endothelial dysfunction may be involved in the development of atherosclerosis [5] [6] [7] and may predate vascular pathology. [ 5 ] [ 8 ] Endothelial dysfunction may also lead to increased adherence of monocytes and macrophages , as well as promoting infiltration of low-density lipoprotein (LDL) in the vessel wall. [ 9 ]
FMD is a noninvasive measure of blood vessel health (endothelial dysfunction [5] [6]) which (when low) is at least as predictive of cardiovascular disease as traditional risk factors. [4] [7] [8] Major cardiovascular disease associated with low FMD include cardiac death, myocardial infarction, and stroke. [8]
The chronic endothelial injury hypothesis is one of two major mechanisms postulated to explain the underlying cause of atherosclerosis and coronary heart disease (CHD), the other being the lipid hypothesis. Although an ongoing debate involving connection between dietary lipids and CHD sometimes portrays the two hypotheses as being opposed, they ...
Endothelial dysfunction has also been shown to be predictive of future adverse cardiovascular events including stroke, heart disease, and is also present in inflammatory disease such as rheumatoid arthritis, diabetes, and systemic lupus erythematosus. [18] [19] Endothelial dysfunction is a result of changes in endothelial function.
Endothelium dysfunction is a prototypical characteristic of vascular disease, which is common in patients with autoimmune diseases such as systemic lupus erythematosus. [20] Further, there is an inverse relationship between age and levels of EPCs. Inverse of endothelial dysfunction also occurs when other risk factors are treated. [21]
Circulating endothelial cells (CECs) are endothelial cells that have been shed from the lining of the vascular wall into the blood stream. [1] Endothelial cells normally line blood vessels to maintain vascular integrity and permeability, but when these cells enter into the circulation, this could be a reflection of vascular dysfunction and damage. [2]
Endothelial activation is a proinflammatory and procoagulant state of the endothelial cells lining the lumen of blood vessels. [1] It is most characterized by an increase in interactions with white blood cells (leukocytes), and it is associated with the early states of atherosclerosis and sepsis , among others. [ 2 ]
This endothelial dysfunction leads to impaired myocardial blood flow reserve as evidence by echocardiography. [10] About 50% of diabetics with diabetic cardiomyopathy show pathologic evidence for microangiopathy such as sub-endothelial and endothelial fibrosis, compared to only 21% of non-diabetic heart failure patients. [11]