Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2006 Feb;22 Suppl B(Suppl B):72B-80B.
doi: 10.1016/s0828-282x(06)70990-4.

Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk

Todd J Anderson  1
Affiliations
Review

Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk

Todd J Anderson. Can J Cardiol. 2006 Feb.

Abstract
in English, French

The understanding of the pathophysiology of atherosclerosis has advanced greatly in the past decade. Cardiovascular risk factors increase the likelihood of an adverse event by having a detrimental effect on the blood vessel wall. Abnormal interactions among cholesterol, inflammatory mediators, platelets and the vascular wall lead to atherogenesis and cardiac events. In an effort to better understand this process, develop surrogate end points for clinical trials and, ultimately, better risk stratify individuals, a variety of measures of arterial function have been studied. These include measures of endothelial health and arterial compliance. The current paper reviews the various techniques available for the study of vascular health. While not yet routinely used for clinical care, these measurements provide important insights into the pathophysiology and treatment of atherosclerosis.

La compréhension de la physiopathologie de l’athérosclérose a beaucoup progressé depuis dix ans. Les facteurs de risque cardiovasculaire augmentent la possibilité d’événement indésirable en raison de leur effet néfaste sur la paroi des vaisseaux sanguins. Des interactions anormales entre le cholestérol, les médiateurs inflammatoires, les plaquettes et la paroi vasculaire provoquent une athérogénèse et des troubles cardiaques. Afin de mieux comprendre ce processus, d’élaborer des paramètres ultimes de substitution en vue d’essais cliniques et, en bout de ligne, de mieux stratifier les individus selon leur risque, diverses mesures de la fonction artérielle ont été étudiées. Ces mesures incluent celles de la santé endothéliale et de la compliance artérielle. Le présent article permet d’analyser les diverses techniques disponibles pour étudier la santé vasculaire. Bien qu’elles ne soient pas encore utilisées systématiquement en soins cliniques, ces mesures donnent d’importants aperçus de la physiopathologie et du traitement de l’athérosclérose.

PubMed Disclaimer

Figures

Figure 1)
Figure 1)
Carotid arterial contour. A reflected wave due to increased arterial stiffness generates a systolic wave (Ppk). The difference between this wave and the initial forward-going systolic wave (Pi) is then divided by the pulse pressure (systolic – diastolic pressure [ΔP]) to generate the augmentation index (AIx). AIx = ΔP/pulse pressure (PP). LVET Left ventricular ejection time; Δtp Time to Pi
Figure 2)
Figure 2)
Ultrasound image of the brachial artery. At rest, the diameter is 3.52 mm, and between 60 s and 90 s postocclusion, the hyperemic diameter is 3.80 mm. Flow-mediated dilation = 3.80–3.52/3.52 ×100 = 8.0%
Figure 3)
Figure 3)
Determination of endothelial function by peripheral artery tonometry. This finger tip plethysmograph measures pulse volume amplitude (PVA) in the index finger of both hands at rest, during a 5 min arm occlusion and then postocclusion. The PVA index is the relative increase in PVA postocclusion in the active finger compared with the control finger. Values greater than approximately 1.4 are normal
Figure 4)
Figure 4)
Use of systolic contour to assess endothelial function. The augmentation index (AIx) is measured from a peripheral artery without a generalized transfer function. Measurements are made at rest, in response to the endothelium-dependent stimulus (inhalation of a beta2-agonist) and in response to nitroglycerin (GTN). A fall in AIx with salbutamol is related to nitric oxide release and a decrease in arterial stiffness. Data from reference
See this image and copyright information in PMC

References

    1. Grundy SM, Pasternak R, Greenland P, Smith S, Jr, Fuster V. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: A statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation. 1999;100:1481–92. - PubMed
    1. Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–47. - PubMed
    1. Ridker PM. Evaluating novel cardiovascular risk factors: Can we better predict heart attacks. Ann Intern Med. 1999;130:933–7. - PubMed
    1. Ridker PM, Brown NJ, Vaughan DE, Harrison DG, Mehta JL. Established and emerging plasma biomarkers in the prediction of first atherothrombotic events. Circulation. 2004;109:IV6–19. - PubMed
    1. Stampfer MJ, Ridker PM, Dzau VJ. Risk factor criteria. Circulation. 2004;109:IV3–5. - PubMed