How Does Endothelial Dysfunction Affect Arterial Health? Endothelial dysfunction has been recognized by the medical fraternity as the critical junction between risk factors and clinical disease for over a decade. It is the earliest stage of the cardiovascular disease which can be detected. It is entirely treatable, unlike the atherosclerotic plaque which it can cause and is also reversible. When the matter of arterial health is discussed it is important also to identify whether the patient is susceptible to the risk factor of endothelial dysfunction. Among all the blood vessels in the endothelium is the inner lining. It is considered as the super organ that can regulate key natural biological processes that can ensure homeostasis, oxidative stress, information, and autoimmune disease. The endothelium is a thin layer of smooth flat cells that are lining the inner walls of the blood vessels in the body which number 62,000. As major lifestyle factors of the negative kind begin increasing the oxidative stress can damage the endothelial tissue throughout the body by stiffening the arteries and veins bringing upon the individual various medical concerns including diseases of the kidney, erectile dysfunction, heart attack and stroke, and peripheral vascular disease. Numerous studies which have been conducted have determined that endothelial dysfunction is the ultimate risk among risk factors but is also the earliest detectable stage clinically of cardiovascular disease. Research laboratories in clinical cardiology initially measured endothelial function by injecting acetal choline via
a catheter into the coronary artery for measuring the response by x-ray imaging to specifically measure the change in the diameter of the artery. It was determined that if the diameter of the coronary artery increases it is an indication of healthy endothelial function. On the other hand, if a decrease was observed in the diameter of the coronary artery is indicated and the delayed dysfunction and signs of atherosclerosis. The technique used was invasive and required hospitalization. Moreover, the technique was expensive and not justified for healthy or asymptomatic patients. Scientists developed a research technique in 1992 to assess endothelial dysfunction by using high-resolution US imaging of the brachial artery. The technique required five minutes of occlusion and release of the brachial artery blood flow by using a blood pressure cuff to manually measure the diameter of the brachial artery with the help of a highfrequency ultrasound imaging probe. When the diameter of the brachial artery increased by less than 5% it indicated endothelial dysfunction along with signs of cardiovascular disease. However, when the diameter of the brachial artery increased by more than 10% it was a sign of healthy endothelial function. Despite this discovery being a major step and a useful tool for research laboratories it lacked the feasibility to be used in clinical practices because it required an experienced sonographer and was, therefore, operator dependent. It was only after Itamar medical introduced the EndoPat device that clinicians were able to overcome the difficulties for diagnosing endothelial dysfunction. The EndoPat device utilizes the innovative proprietary PAT technology which can measure the overall health of the endothelial. The PAT signal
is measured from the fingertip by recording volume changes of the arterial pulsatile. The higher the amplitude of the PAT the patient had a better vascular function. EndoPat provided results in 15 minutes which could be calculated automatically to generate an EndoScore which indicates the current condition of endothelial health. Moreover, the EndoPat device is interpreter and operator Independent and it provides results that can be reproduced. As one of the ultimate risk factors for arterial health endothelial dysfunction is an indicator that a patient could be suffering from cardiovascular disease. Detecting it early can ensure the patient receives the treatment he or she needs to improve their cardiovascular health.