The assessment of endothelial function: from research into clinical practice.
The assessment of endothelial function: from research into clinical practice.
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内皮功能的评估：从研究到临床实践。
DOI：
10.1161/circulationaha.112.093245
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发表时间：
2012-08-07
期刊：
影响因子：
37.8
通讯作者：
Lerman A
中科院分区：
文献类型：
--
作者：
Flammer AJ;Anderson T;Celermajer DS;Creager MA;Deanfield J;Ganz P;Hamburg NM;Lüscher TF;Shechter M;Taddei S;Vita JA;Lerman A
内皮作为调节血管生理需要的重要器官的发现，以及内皮功能障碍作为一种关键病理状态的认识——它与大多数（如果不是全部的话）心血管危险因素相关——导致了内皮研究在过去30年的巨大推动。尽管测量个体内皮功能的可能性及其在研究中的广泛应用，但其作为日常医学临床工具的用途尚未建立。我们回顾了最常用的评估人类血管功能的方法，并讨论了它们的优缺点。此外，我们给出了关于临床设置的概述，内皮功能测量可能是有价值的个别患者。具体来说，我们提供了为什么内皮功能不仅是心血管风险的风险标志，而且还可以提供预后信息，而不仅仅是在初级预防中常用的风险评分，以及在已经患有冠状动脉疾病的患者中。我们的结论是，非侵入性内皮功能测量提供了有价值的附加信息，然而，为了确定其在日常临床实践中的应用，未来的研究应该确定内皮功能是否可以用于指导个体治疗，以及是否转化为更好的结果。
The discovery of the endothelium as a crucial organ for the regulation of the vasculature to physiological needs and the recognition of endothelial dysfunction as a key pathological condition - which is associated with most if not all cardiovascular risk factors - led to a tremendous boost of endothelial research in the past 3 decades. Despite the possibility to measure endothelial function in the individual and its widespread use in research, its use as a clinical tool in daily medicine is not established yet. We review the most common methods to assess vascular function in humans and discuss their advantages and disadvantages. Furthermore we give an overview about clinical settings were endothelial function measurements may be valuable in individual patients. Specifically, we provide information why endothelial function is not only a risk marker for cardiovascular risk but may also provides prognostic information beyond commonly used risk scores in primary prevention, and in patients with already established coronary disease. We conclude, that non-invasive endothelial function measurements provide valuable additional information, however, to ascertain its use for daily clinical practice, future research should determine whether endothelial function can be used to guide treatment in the individual and if this translates into better outcomes.