Is reversal of endothelial dysfunction still an attractive target in modern cardiology?

Abstract

Although the endothelium has a number of important functions, the term endothelial dysfunction is commonly used to describe impairment in its vasodilatory capacity. There have been numerous studies evaluating the relationship between endothelial dysfunction and cardiovascular disease, however assessment of endothelial function is perhaps still primarily thought of as a research tool and has not reached widespread clinical acceptance. In this review we explore the relationship between endothelial dysfunction and cardiovascular disease, its prognostic significance, methods of pharmacological reversal of endothelial dysfunction, and ask the question, is reversal of endothelial dysfunction still an attractive target in modern cardiology?

Keywords: Endothelium, Vascular, Nitric oxide, Atherosclerosis, Risk factors, Flow-mediated dilatation

Core tip: There is an abundance of evidence suggesting that endothelial dysfunction is present throughout a wide spectrum of cardiovascular disease and is an independent indicator of adverse prognosis. Despite this, perhaps due to lack of standardisation of investigative techniques, endothelial function assessment is not yet routinely undertaken, despite a number of therapies which have been shown to have beneficial effects on the endothelium. More studies are required to judge whether assessment of endothelial function can impact on clinical management and prognosis.