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Vascular Endothelial Function

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Abstract

Our understanding of the endothelium as an important moderator of vascular function has evolved significantly over the last several decades. Initially viewed as an inert interface between circulating blood and the vessel wall, we now acknowledge its complex and central role in the regulation of vascular tone, inflammation, homeostasis, permeability, and proliferation. Healthy endothelium is vital for maintenance of normal vascular function, balancing vasodilatory and vasoconstrictive influences, maintaining an antithrombotic microenvironment, and mediating the flow of nutrient substances, blood cells, and diverse biologically active molecules across the monolayer. However, failure to adapt to physiological or pathological stimuli may activate aberrant compensatory mechanisms that alter the endothelial phenotype and promote endothelial dysfunction, a pro-thrombotic, pro-proliferative, proinflammatory, and pro-constrictive phenotype. In the presence of traditional or novel risk factors of atherosclerosis, endothelial function degenerates prior to the appearance of morphological vascular changes. This endothelial dysfunction is readily measured through both invasive and noninvasive means and is predictive of future risk of adverse cardiac events. Coupled with efforts to investigate the hemodynamic, biochemical, and molecular processes underlying long-term changes in endothelial properties, therapeutic strategies to alleviate endothelial dysfunction provide a promising pathway to guide future therapeutic interventions and reduce cardiovascular morbidity and mortality.

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Abbreviations

Endothelium:

The endothelium is the thin monolayer of cells that lines the inner surface of the blood vessels forming an interface between circulating blood in the lumen and the rest of the vessel wall. The cells that form the endothelium are called endothelial cells.

Endothelial Dysfunction:

Endothelial dysfunction is an alteration of the endovascular lining of the blood vessels in response to various stimuli that is characterized by a pro-thrombotic, proinflammatory, pro-constrictive, and pro-proliferative phenotype.

Flow-Mediated Dilation:

Endothelial function is often quantified by flow-mediated dilation (FMD), which represents the endothelium-dependent relaxation of a conduit artery – typically the brachial artery – due to an increased blood flow. Brachial artery reactivity is frequently used in noninvasive ultrasonographic assessment of FMD that indicates endothelium-dependent response to shear stress.

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  1. Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Ave, FEC E5100, Milwaukee, WI, 53226, USA

    Dr. Michael E. Widlansky M.D., MPH (Associate Professor of Medicine and Pharmacology) & Mobin A. Malik M.D., MS (Research Fellow)

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    Peter Lanzer

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Widlansky, M.E., Malik, M.A. (2014). Vascular Endothelial Function. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_8-1

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